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FALLACIES  OF  THE  FACULTY. 


THIRTEENTH  EDITION. 


PRICE    ONE    DOLLAR 


'jM 


CASS 


THE  PRINCIPLES 


CHRONO ■ THERMAL 

SYSTEM  OF   MEDICINE, 


WITH    THE 


FALLACIES  OF  THE  FACULTY, 

IN     A     SERIES     OF     LECTURES, 

BY 

SAMUEL    DICKSON,  M.D. 

FORMERLY   A   MEDICAL   OFFICER   ON    THE    BRITISH    STAFF. 
CONTAINING   ALSO, 

AN    INTRODUCTION   AND    NOTES 

BT 

WILLIAM  TURNER,  M.D., 

EX-HEALTH    COMMISSIONER    FOR   THE    CITY    AND    COUNTY    OF    NEW    YORft,    FELLOW 
OF   THE    SCIENTIFIC    AiJD    MEDICAL-ECLECTIC    COLLEGE    OF   VIRGINIA,    ETC. 

THIRTEENTH  EDITION. 


NEW   YORK: 

LONG  &  BROTHERS,  41  (LATE  46)  ANN  STREET. 

18P0. 


gjgS 


"  Look  at  these  two  men  about  to  be  buried — they  were  brothers,  and  had 
\.he  same  disease — but  they  treated  themselves  differently.  One  had  a  blind 
confidence  in  his  doctor — the  other  left  liimself  entirely  to  nature  ; — both,  ne- 
vertheless, are,  as  you  see,  on  their  way  to  their  long  home — the  first  because 
he  took  all  the  physic  ordered  him — the  second  because  he  would  take  none  at 
all."  "  How  very  embarrassing !"  said  Leandro.  "  What,  in  such  a  case, 
Friend  Asmodeous,  would  you  advise  a  poor  patient  to  do  ?"  "  Ah  !  I  wish  I 
could  tell  you  that,"  replied  the  Cripple  ;  "  I  know  plenty  of  good  remedies, 
bat  it  would  puzzle  us  both  to  find  a  good  doctor  !" — Le  Sage's  Diablc  Boiieux. 


TO  MRS.  GENERAL  GAINES. 
Madam, 

It  is  related  of  the  heroic  and  patriotic  Mary  Wortley  Montague, 
who  introduced  into  England  a  great  medical  improvement  for  her 
day — the  small-pox  inoculation — such  was  the  malice  of  its  ene- 
mies, that,  though  supported,  in  addition  to  the  prestige  of  aristocra- 
tic rank,  by  a  Princess  of  the  Blood,  she  all  but  sunk  under  the  dif- 
ficulties of  her  undertaking.  How  far,  under  our  simpler  institu- 
tions, the  liberality  manifested  by  you,  whose  chief  distinction  con- 
sists in  your  faithful  and  exemplary  discharge  of  the  duties  apper- 
taining to  the  endearing  relations  of  daughter,  wife  and  mother,  in 
permitting  me  to  dedicate  to  you  this  edition  of  a  work  subversive  of 
the  entire  fabric  of  "  established  medicine,"  may  neutralize  the  sa- 
vage rancour  of  persecution,  I  am  unable  to  predict.  If,  however,  it 
shall  be  the  means  of  attracting  the  attention  of  the  women  of  our 
country  filling  the  delightful  domestic  offices  to  which  I  have  advert- 
ed, to  a  system  calculated  to  enable  them,  under  judicious  advice,  to 
disarm,  in  innumerable  instances,  pain  of  its  intensity,  disease  of  its 
severity,  and  to  put  the  King  of  Terrors  himself  at  bay,  they  will 
agree  with  me,  that  your  sagacity,  courage,  and  patriotism  are  wor- 
thy of  a  nation's  gratitude. 

I  have,  the  honor  to  be,  Madam, 
With  profound  respect, 

Your  obliged  and  obedient  servant, 

Wm.  Turner. 


CO 


)<>b 


CONTENTS. 


Preface  - 

Dr.  Turner's  Introduction 

Sketch  of  Dr.  Dickson    - 

LECTURE  I. 


Introduction  - 
Phaenoinena  of  Health  - 
Of  Sleep       - 


Pfannnr 

Causes  of  Disease  -        -        -        - 

LECTURE  II. 
Intermittent  Fever,  or  Ague  - 
Spasmodic  Complaints   - 
Palsy  or  Paralysis  -         -         -         - 
Disorders  of  Sensation   - 

LECTURE  III. 
Hereditary  Predisposition 

Apoplexy 

Haemorrhage,  or  ruptured   Blood- 
vessels        - 
Diseases  of  the  Heart     -        -        - 
Pulmonary  Consumption,  or  Phthisis 
Glandular  Disease  - 
Consumptive  Diseases  of  Joints 

LECTURE  IV. 

Inflammation 

Blood-letting 

Abstinence,  or  Starvation 

LECTURE  V. 
Medical  Doctrines,  Old  and  New  - 

Gout 

Rheumatism  - 

The  Stone 

Cutaneous  Disease  -        • 
Variola,  or  Small-pox      - 

Plague 

Yellow  Fever         - 

Dysentery 

Dropsy  ------ 

Cholera 


Page 


99 

H>4 
109 
111 
112 
ill 
LI6 
117 
LIS 
118 
118 


LECTURE  VI. 
Present  state  of  Medical  Practice  in 

England     -       •  -       -  120 

i  ■  \  or  Indigestion       -        -  123 

11%  [locliuiuliia,  or  Hysteria    -        -  130 

Insanity 131 

Bffecl  ol  Ligature-       -       -       -  136 

Faint 187 

'  ^u 137 

liiiaiiiii.-  Convulsions     -       -       -  140 

LECTURE  VII. 

Unity  of  all  things*       -       -        -  148 

incidental  to  Women       -  145 

Dancer  ol  the  lw-east     -       -       -  M7 


Pago 
151 
158 
153 
154 
154 
157 


157 
158 
162 
170 
171 
173 
173 


179 
183 


187 
189 


191 


Tumors  ------ 

Pregnancy     

Parturition      ..'-•'• 
Abortion,  or  Miscarriage 

Teething 

Hereditary  Periodicity  - 

LECTURE  VIE. 
The  Five  Senses    -        -        -        - 
Animal  Magnetism 
The  Passions  -        -        -        -        - 

Baths 

Exercise 

Plasters,  Blisters,  Ointments,  &c.  - 
llomneopathy  .... 

LECTURE  IX. 
Physic  and  Poison  Identical  - 
Remedial  Means    -        -        -        - 
Action    of    Medicinal    Substances 

proved  to  be  Electrical 
Particular  Remedies,  and  why  they 
affect  particular  parts 

Emetics 

Purgatives 

Mercury 

Iodine         - 

Lead " 

Tar — Creosote    -        -        -  " 

Sulphur 192 

Colchicum,  or  Meadow  Saffron  -       " 
iSc[iiill.  Digitalis  -        -        -        -      •■ 
Stramonium,  or  Thorosppla 
Tobacco.  Lobelia  Inflata    - 
The  Balsams  and  Gun*      -        -    193 
Oantharides.  or  Spanish  Fry        -      " 
The  Earths  and  Alkalis       -         -       ■' 
The  Acids " 

LECTURE  X. 
The  Chrono-Thennal  Remedies: — 
The  Peruvian  Hark    -         -         -     194 
Acid        ....     197 
Opium,  ami  its  Salts  of  Mcjrphia-     108 
Alcohol,  Wine, and  Malt  Liquors     199 
Musk.  Valerian,  Camphor,  Assa- 
footida    -----    goo 

Strychnia " 

Silver 20. 

Copper 202 

Iron 

Zinc  and  Bismuth       ..." 

Arsenic 

Summary  of  the  Chrono-Thermal 

Doctrine 204 

Appendix  ! — 

Letters  to  the  Author 
Dr.  Forbes'  Trickery-       -       -    215 
Dr.  Leycock'i  ditto    -       -       -    215 
Dr.  Copland's  ditto    -        -        -    BM 
Dr.  Turner'.-  Notes      ..." 


PREFACE 

TO 

THE  FOURTH  BRITISH  EDITION. 


"  What  have  the  physicians  been  about  the  last  four  thousand  years  1  The  an- 
swer to  that  question  will  be  found  in  the  following  pages  .'" 

Such  is  the  question — such  the  reply  with  which  the  eminent  Health  Commission- 
er for  the  City  and  County  of  New  York  introduces  the  Chrono-Thermal  System  of 
Medicine  to  his  countrymen  in  the  new  West.  The  nattering  terms  with  which  Dr. 
Turner  has  expressed  his  acknowledgements  to  me  in  his  Introduction  to  the  A4ne- 
rican  Reprint  of  my  labours,  contrast  somewhat  curiously  with  the  reception  they 
have  met  nearer  home.  To  the  author  of  the  Chrono-Thei-mal  System  he  thus 
writes : 

"New  York,  MayUth,  1845. 

"  Dear  Sir, — This  note  will  be  handed  to  you  by  my  friend  Mr.  Richard  Burlew, 
a  merchant  of  this  city,  who,  visiting  England  on  business,  and  intending  to  pass 
a  few  days  in  your  metropolis,  has  kindly  undertaken  to  place  in  your  Hands  a  copy 
of  an  edition  of  your  <  Fallacies  of  the  Faculty,' which  I  have  had  reprinted  here. 
He  has  also  been  good  enough  to  undertake  another  commission  for  me,  viz.  to 
make  an  arrangement  with  some  Daguerreotypist  in  Loudon  to  take  your  likeness 
for  me,  if  you  will  do  me  the  great  favour  to  sit  for  it. 

"  The  reprint  of  your  book  is  too  recent  to  enable  me  to  inform  you  as  to  the  re- 
sult. But  I  think  the  obstacles  to  a  full  reception  of  your  beautiful  System  in  Ame- 
rica, are  not  so  great  as  they  have  been  with  you.  The  daily  press  here  takes  cogni- 
zance of  such  works.  And  thus  far  I  have  no  reason  to  complain  in  this  respect. 
My  edition  consists  of  1000  copies. 

"  I  hope  to  communicate  further  with  you  hereafter,  and  would  be  pleased  to  re- 
ceive any  hints  or  suggestions  you  may  have  to  offer  to  your  new  disciple  in  this 
Western  Hemisphere.  Let  me  add,  that,  if  I  can  in  any  way  promote  your  views 
or  wishes  in  this  quarter,  I  shall  be  most  happy  to  receive  your  commands.  With 
unfeigned  regard,  "  Your  friend  and  obedient  servant, 

"  Wm.  Turner. 

"  Dr.  Dickson,  Bolton  Street,  Piccadilly,  London." 

On  a  suggestion  which  the  reader  will  find  in  Dr. Turner's  Introduction,  the  "  Fal- 
lacies of  the  Faculty"  is  now  again  presented  to  the  public  under  its  second  title — 
The  Chrono-Thermal  System  of  Medicine.  In  the  face  of  much  opposition,  this 
system  has  already  made  its  way  pretty  well  in  the  world.  Reprinted  in  America, 
it  has  had  the  further  honour  to  be  translated  into  three  of  the  continental  languages 
— French.  German,  and  Swedish ;  while  the  sale  of  nearly  six  thousand  copies  of 
former  editions  in  this  countiy  speaks  favourably  for  its  reception  among  the  British 
people.  When  I  come  to  relate  how  it  has  been  received  by  the  Medical  Profession, 
the  great  body  of  them,  I  fear,  will  not  feel  much  flattered,  either  by  the  matter  or 
the  manner  of  the  relation. 

Fifteen  years  ago  it  was  my  fate — I  can  scarcely  call  it  my  fortune — to  make  two 
most  important  discoveries  in  Medicine, — namely,  the  Periodicity  of  Movement  of 
every  Organ  and  Atom  of  all  Living  Bodies — and  the  lutennittency  and  Unity  of 
All  Diseases,  however  named,  and  by  whatever  produced.  To  these  I  added  a  third 
— the  Unity  of  Action  of  Cause  and  Cure, — both  of  which  involve  Change  of  Tern- 


vi  PREFACE  TO  THE  FOURTH  LONDON  EDI 

perature.     Such  is  the  groundwork  of  the  Chrono-Thermal  S  d  from 

Ckronos,  Time  or  Period ;  aud  Tlicrma,  Temperature  Or  Heat.  This  I  gave  to  the 
public  in  1836.  Then,  for  the  first  time,  I  announced  the  appalling  fact,  that  up 
to  that  hour  the  Professors  of  the  Healing  Art  had  been,  to  a  man,  iu  all  but  utter 
darkness  on  the  subject  they  pretended  to  teach.  From  the  days  of  Hippocra- 
tes, I  indisputably  proved,  that  when  the  Physician  succeeded  in  the  Cure  of  Di- 
sease, he  did  so — in  Irish  phrase — by  accident,  on  purpose  !  Thirty  centuries  and 
upwards  the  Blind  had  been  leading  the  Blind  in  Medicine — the  right  way  some- 
times— more  frequently  the  wrong  !  Was  it  wonderful  that  a  revelation  so  startling 
should  come  upon  the  Profession  like  a  thunderbolt  ?  Silently,  secretly,  however, 
it  has  been  gaining  converts  ever  since  from  their  ranks.  Like  the  Religion  of  the 
Reformation  in  its  earlier  struggles,  the  Chrono-Thermal  System  has  been  embraced 
and  practised  by  thousands  who  have  neither  the  courage  nor  the  honesty  to  dare 
the  avowal.  To  those  gallant  men.  who  have  openly  come  forward  to  bear  tes- 
timony to  its  worth,  I  want  words  to  express  my  gratitude.  How  but  for  them 
could  I  have  so  long  stood  against  the  organised  opposition  of  the  Schools — the  Bro- 
dies,  the  Chambers',  the  Clarks, — who,  with  their  clique  of  pedantic,  sycophantic 
supports,  conspired  to  cry  me  down  for  my  efforts  to  cleanse  the  Augean  Stable  of 
British  Medical  Practice  of  its  filth  and  corruption  ?  Could  the  London  world  but 
know  the  arts  by  which  certain  men  have  got  a  name,  with  what  astonishment 
would  it  stare  to  find  itself  precisely  in  the  position  of  a  deluded  savage,  when,  for 
the  first  time,  he  discovered  the  utter  worthlessnesB  of  the  red  and  green  glass,  for 
which,  year  after  year,  he  had  been  unsuspiciously  bartering  his  wealth  !  Iu  the 
dark,  pigmies  seem  giants ;  Britain  only  knows  her  great  men  when  they  are  dead. 
On  Harvey  and  Jenncr,  while  they  lived,  the  beams  of  her  warming  sun 
shone; — she  all  but  deferred  to  acknowledge  their  merits  till  she  saw  them  on  their 
deaths,  surrounded  with  that  halo  of  immortality  which  all  the  nations  of  the  earth 
united  to  bestow  on  them. 

The  Chrono-Thermal  System  of  Medicine  has  shared  the  fate  of  every  truly  great 
discovery.  Translated,  reprinted,  and  landed  abroad,  it  was  first  denied,  decried, 
then  plagiarised  at  home.  And  now,  at  the  eleventh  hour,  (or  year!)  when  France, 
Germany,  Sweden,  and  America,  have  each  come  forward  to  speak  to  its  worth,  I, 
its  author,  find  myself  here  in  England  exposed  to  the  hourly  abuse  of  men  who 
gain  their  bread  by  practising  in  secret,  or  under  some  paltry  disguise,  the  very 
principles  they  have  surreptitiously  pilfered  from  me!  Who  does  not  remember 
the  London  Practice  of  Physic  only  ten  yean  ago — the  barbarities  practised  under  ' 
the  name  of  medicine?  Leech,  lancet,  and  calomel — where  are  they  now — those 
so-called  sheet-anchors  of  the  Medical  Art  ?  The  change  that  in  that  short  time 
has  been  accomplished  in  Physio,  is  aot  less  great  than  what  has  taken  place  mow 
mode  of  Locomotion  through  the  agency  of  steam.  Ten  years  ago,  where  was  the 
madman  so  foolhardy  n<  to  declare  thai  the  Latieel  could  be  dispensed  with  in  Apo- 
plexy 1     Nearly  ten  yens  it  i*,  liowever.  since  I  first  had  to  run  1  he  moral  gauntlet  for 

explaining,  not  only  thai  this  oonld  I"-  done,  but  that  the  employment  of  the  I 
is  the  most  certain  course  to  render  thai  disease  fatal  I    And  here  ban 
1845,  Books,  Pamphlets,  and  Beviews  all  corroborating  tho  fact,  but  stodioasly  con- 
cealing tin-  name  of  him  who  first  annooneed  it!   The  Editor  of  the  IfriWiwf  T 
one,  will  not  deny,  thai  when  he  first  printed,  as  a  marveL  s  case  of  apopiuiy  that 
bad  l"'  Heated  without  Bleeding  by  Mr.  Baldy,  of  Davenport, 

was  his  dread  of  the  professional  oonepiraoj  against  me,  be  was  obliged  to  draw  his 

pen  through  tfa  he  narration    that   alluded    to    Dr.  l>uk>on  as   the  first 

teaoher  of  the  new  treatment ! 

Nothing  can  more  forcibly  SOOW  the  value  of  an  article,  than  attempts  to  steal  it. 
Would  a  pickpocket  risk  detection  for  ID  empts  pOXSQ  '      The  first  who   committed 


PREFACE  TO  THE  FOURTH  LONDON  EDITION.  vii 

himself  in  this  manner  was  Dr.  Henry  Holland,  a  physician  of  the  Court.  In  1839, 
Dr.  Holland,  fyr  the  first  time,  hazarded  as  a  prophecy,  what  I  had  not  only  proved,  but 
printed  as  a  fact  in  183G, — namely,  the  Intermittency  of  all  disease.  Then,  too,  for 
the  first  time,  he  suggested  as  a  probable  danger,  the  employment  of  the  Lancet  in 
Apoplexy.  Successively  and  under  new  disguises,  new  plagiarisms  followed.  Sir 
C  Bell,  Hood,  Copeman,  Dr.  Searle  and  others,  pretending  to  repudiate  the  Chro- 
no-Thermal  principle,  adopted  the  Chrono-Thermal  practice.  I  know  not  if  Dr. 
Searle  be  the  same  person  who  sent  me  his  pamphlet  about  the  Gases,  "  with  the 
author's  respectful  compliments  and  admiration"  inscribed  on  the  title-page.  Somo 
such  similar  expression  in  the  body  of  the  book  he  lately  printed,  "  On  the  Tonic 
Treatment  of  Diseases  of  the  Brain,"  would  have  spared  me  the  necessity  of  telling 
the  world  that  the  practice  he  advocates  in  those  diseases  is  borrowed  entirely  from 
me.  Sir  George  Lefevre,  I  regret  to  find,  has  followed  in  the  same  slippery  track 
— quoting  Dr.  Holland,  instead  of  me,  on  the  subject  of  Apoplexy.  "  Dr.  Baillie 
said  in  his  day  that  Palsy  was  upon  the  increase.  It  is  not  improbable  (remarks 
Sir  George)  that  the  UNIVERSAL  syBtem  of  blood-letting  upon  all  such  attacks, 
and  even  threatenings  of  them,  has  converted  remedial  into  incurable  diseases.  Pa- 
ralysis has  sometimes  immediately  followed  the  depletion  intended  to  prevent  Apo- 
plexy." Here  the  practice  he  condemns  is  admitted  to  be  "  universal."  To  whom 
must  we  attribute  this  universality  of  a  bad  practice  ?  To  whom  but  to  the  teach- 
ers in  the  various  medical  schools — the  so-called  leaders  of  the  medical  world — the 
Brodies,  the  Chambers',  and  others  of  that  stamp,  who  have  so  long  led  the  Profes- 
sion by  the  nose,  and  the  Public  by  the  ear !  Winter  after  winter  in  their  Lectures 
at  St.  George's  Hospital,  did  Sir  Benjamin  Brodie  and  Dr.  Chambers  assure  their 
worshipping  pupils  that  the  Lancet  and  the  Leech  are  the  sheet-anchors  of  Apo- 
plexy. "Bleed!  bleed!  bleed!"  was  their  cry— and  bleed,  bleed,  bleed!  was 
their  practice.  Of  what  slaughter  have  not  these  men  been  the  cause  1  Said  I  not 
truly,  The  Blind  have  been  leading  the  Blind  in  Medicine  ?  By  the  terrible  doc- 
trines they  have  so  long  taught,  must  Sir  B.  Brodie  and  Dr.  Chambers  now  stand  or 
fall.  Among  the  multitude  of  fools  they  may  still  find  patients.  The  clique  of  sy- 
cophants who  professionally  support  them,  already  begin  to  turn  with  the  turning 
stream.  One  word  to  Sir  George  Lefevre,  who  has  so  unconsciously  helped  to  this 
exposure.  Why,  when  this  good  travelling  physician  was  so  elaborate  on  the  new 
treatment  of  Apopl  oxy,  did  he  omit  to  name  the  real  author  of  that  treatment  in  his 
work  ?  and  how  came  he  to  call  his  treatise  "  An  Apology  for  the  Nerves  ?"  His 
nerves  only  require  an  apology,  who  conspires  to  rob  geuius  of  its  due.  The  next 
book  Sir  George  indites,  may  possibly  be — An  Apology  for  Himself ! 

The  Chrono-Thermal  Principle  is  denied,  disguised,  plagiarised,  and  whispered 
away — the  Chrono-Thermal  Practice  secretly  triumphs  in  every  hand !  Dr.  Cop- 
land, it  is  true,  in  his  peculiar  fashion,  has  admitted  the  correctness  of  both  ;  but  to 
account  for  it,  he  contends,  that  within  the  last  five  and-twenty  years  Disease  has 
changed  its  type — that  the  physical  constitution  of  man  has  changed  its  character  i 
Pity  he  did  not  sooner  announce  his  discovery  !  For  something  like  five-and-twenty 
years  has  this  very  Dr.  Copland  been  ever  and  anon  favouring  the  public  with  his 
notions  about  Medicine.  But  not  till  the  year  of  Grace  1844,  did  he  tell  the  be- 
nighted world,  that  the  diseases  of  mankind  had  ceased  to  be  continual,  and  had  all 
[to  gratify  Dr.  Dickson?]  taken  on  the  Intermittent  Type — that  the  Lancet  and  the 
Leech  must,  henceforth,  give  way  to  Bark  and  Tonics  "  even  in  Inflammation  of 
the  Chest !"  Ah!  Dr.  Copland,  why  not  confess  at  once  you  had  just  been  taking 
a  peep  at  Disease  through  Dr.  Dickson's  spectacles  ?  As  it  is,  you  have  unwittingly 
paid  him  a  compliment  at  the  expense  of  your  integrity,  your  honour,  ami  your 
understanding.  The  Type  of  Disease  change  !  Forms  change  ;  Types  are  immuta- 
ble !     A  Continual  Disease !     Who  ever  heard  of  an  eternal  tempest  or  an  eternal 


riii  PREFACE  TO  THE  FOURTH  LONDON  EDITION. 

storm  ?  From  the  beginning  of  Time  there  never  was  a  continual  disease — a  conti- 
nual tempest  of  the  human  body  !  How  degrading  these  piratical  attempts  to  tako 
my  Bark,  and  throw  its  owner  overboard  !  They  afford  an  index,  however,  to  the 
present  morale  of  the  Profession.  Vain  will  be  its  calls  upon  any  government  to  re- 
form it,  till  its  members  shall  bare  first  individually  learnt  to  reform  themselves. 

Among  the  pitiful  persons  who  have  been  thus  amusingly  employing  themselves, 
I  must  not  forget  to  notice  a  country  practitioner,  of  the  name  of  Laycock,  who 
figures  as  a  member  of  the  British  Association  for  the  Advancement  of  Science. 
"  The  British  Association,"  we  are  told  by  the  Times  newspaper,  "  began  at  York  ; 
— what  it  has  brought  forward,  of  new,  is  not  true— what,  of  true,  is  not  new  !" 
From  this  sweeping  condemnation  of  the  Times  I  wholly  dissent.  The  Herschells, 
the  Bucklands,  the  Sedgwicks,  the  Murchisons,— -Faraday,  Brewster,  Airey,  have 
laboured  too  successfully  in  science,  not  to  rebut  with  all  sensible  people,  this  lan- 
guage of  the  Times.  These,  with  other  illustrious  names,  belong  to  the  British 
Association.  But,  unfortunately,  connected  with  it  also,  is  a  rather  noisy  class  of 
people — principally  of  the  Doctor  tribe — who  hope  to  emerge  from  obscurity,  by 
clinging  to  the  mantles  of  the  truly  great  men  who  belong  to  it.  Of  this  excep- 
tional class  is  Doctor  Laycock.  To  him  and  to  his  doings,  the  censures  of  the  Times 
completely  apply.  He  began  at  York.  At  York,  in  1842,  by  means  of  a  false  tail 
and  other  Yorkshire  tricks,  he  disfigured  and  disguised  my  hobby,  Vital  Periodi- 
city, to  pass  it  off  afterwards  as  his  own  at  one  of  the  meetings  of  the  British  As-, 
aociatiou.  Not  content  with  this,  he  did  the  same  in  the  Lancet;  and,  some  time 
after,  he  repeated  the  offence  in  Forbes*  Medical  Review— that  well-known  recep- 
tacle of  stolen  property.  Blush  !  Messrs.  Chambers,  for  having  allowed  him  to  do 
the  same  in  your  respectable  Edinburgh  Journal.  As  a  specimen  of  the  false  tail 
he  tacked  to  my  hobby,  let  me  give  the  first  joint : — "A  day  of  ttcelvc  hours," 
quoth  Laycock,  "  is  the  basil  unit  of  Vitul  Periodicity."  The  merest  schoolboy 
could  tell  him,  that  a  day,  being  the  measure  of  one  full  revolution  of  the  Earth, 
takes  twenty-four,  instead  of  twelve  hours,  for  its  accomplishment ;  and  that  the 
basil  unit  of  all  Periodicity  must  necessarily  be  the  smallest  portion  of  Time  the 
mind  can  imagine — a  secoml  being  sufficient  for  every  practical  purpose.  My  let- 
ters in  the  Medical  Times  very  speedily  stripped  this  jackdaw  of  his  borrowed  lea- 
thers. With  a  perseverance,  however,  worthy  of  a  better  cause,  1  find  him  again 
at  his  tricks  with  the  British  Association.  Only  within  the  last  few  weeks,  the  Bo- 
tanical Zoological  Section  of  that  body — all  doctors,  of  course — appointed  a  com- 
mittee to  inquire  into  the  '•  Periodicity  of  Plants  and  Animals," — got  up,  I  happen 
to  know,  at  the  instance  of  Mr.  Laycock,  to  shield  him  and  his  delinquencies  from 
the  scorn  and  contempt  of  a  profession  he,  and  so  many  people  like  him,  have  de- 
graded. Oh,  for  the  report  of  this  precious  Committee  !  The  Periods  of  sou  inc. 
planting,  llowering  and  reaping, — "  annuals,"  "  biennials,"  "  septeunials,"  and  so 
forth, — taken  for  the  nonce  from  the  (lardc/irr'.s  Chronic'r,  when  prettily  d 
up  with  a  certain  imposing  leehnic alityof  manner  will  furnish  forth  ■  highly  origi- 
nal dish  on  tin;  Periodicity  of  Plants.  While  the  plundered  content!  of  mj  volume', 
variously  distorted,  and  mixed  up  with  the  history  and  haliits  df  Birds  and    Beasts, 

— not  forgetting  the  nidification,  egg-hatching,  and  breeding  of  the  prim*  •■  I 

and  class  "  Reptile,'' — the  cackling  and  slimy  civatures  with    which   tin  v  a  ■ 

miliar, — will  be  reproduced  as  ■  scientific  novelty  on  Animal  Periodicity.  On  this 
particular  occasion  th'-  pilfering  Magpie,  l>\  desire,  will  be  lefl  oat  ;  so  also,  per- 
haps, will  be  the  mare's  nesl  of  ••  a  hours."  The  whole  performance, 
however,  to  conclude  with  a  handsome  compliment  to  the  talented  author  of  the 
discovery —  Doctor  Leyeook,1he  quondam  Jfora  apothecary.     Alas!  for  the  learned 

k — to  have  his  name  and  his  faun;  withered    in  a    inotii' 

m  of  the  little  word,  Dates.     For  those  andsomi  Per  the 

reader  to  the  oorre  tpoudence  In  the  Appendix. 

28,  I 


DR.    TURNER'S   INTRODUCTION 

TO 

THE  FIRST  AMERICAN  EDITION. 


This  work  was  published  in  London  under  its  second  title,  "  Fallacies  of  the  Fa- 
culty," a  phrase  which  does  not  convey  a  proper  idea  of  the  important  character  ot 
the  production ;  like  the  "  Curiosities  of  Literature,"  and  so  forth,  it  might  rather 
lead  people  to  suppose  it  designed  simply  to  attract  the  attention  of  the  curious,  or 
to  divert  the  idle.  Hence,  with  due  deference  to  the  author,  I  have  given  promi- 
nence to  what  he  had  made  the  second  branch  of  its  title,  as  best  calculated  to  indi- 
cate the  use  and  nature  of  the  book. 

Dr.  Dickson's  views  of  disease  are  simple  and  easily  understood.  "  More  than 
twenty-three  centuries,"  he  says,  "  have  elapsed  since  Hippocrates  distinctly  an- 
nounced the  Unity  of  Morbid  Action — omnium  morborum  unus  et  idem  modus  est — The 
type  of  All  Disease  is  one  and  identical.  These  are  his  words,  and  that  is  my 
case.  That  is  the  case  upon  which  unprejudiced  and  disinterested  posterity  will 
one  day  pronounce  a  verdict  in  my  favour, — for  the  evidence  I  am  prepared  to  ad- 
duce in  its  support,  will  be  found  to  be  as  perfect  a  chain  of  positive  and  circum- 
stantial proof  as  ever  was  offered  to  human  investigation."  This  "  Type"  is  fever 
and  ague,  or  Intermittent  Fever. 

The  following  are  the  conclusions  to  which  Dr.  Dickson  arrives  on  the  subject  of 
Health  and  Disease : 

1.  The  phenomena  of  perfect  Health  consist  in  a  regular  series  of  alternate  mo- 
tions or  events,  each  embracing  a  special  Period  of  time. 

2.  Disease,  under  all  its  modifications,  is  in  the  first  place  a  simple  exaggeration  at 
diminution  of  the  amount  of  the  same  motions  or  events,  and  being  universally  alter- 
native with  a  Period  of  comparative  Health,  strictly  resolves  itself  into  Fever — Re- 
mittent or  Intermittent,  Chronic  or  Acute ; — eveiy  kind  of  structural  disorganization, 
from  Tooth-Decay  to  Pulmonary  Consumption,  and  that  decomposition  of  the  knee- 
joint,  familiarly  known  as  White  Swelling,  being  merely  developments  in  its  course : 
— Tooth-consumption,  Lung-consumption,  Knee-consumption. 

3.  The  tendency  to  disorganisation,  usually  denominated  Acute,  or  Inflammatory, 
differs  from  the  Chronic  or  Scrofulous  in  the  mere  amount  of  motion  and  tempera- 
ture ;  the  former  being  more  remaikably  characterised  by  excess  of  both,  conse- 
quently exhibits  a  more  rapid  progress  to  decomposition  or  cure ;  while  the  latter 
approaches  its  respective  terminations  by  more  subdued,  and  therefore  slower  and 
less  obvious  terminations  of  the  same  action  and  temperature.  In  what  does  con- 
sumption of  a  tooth  differ  from  consumption  of  the  lungs,  except  in  the  difference 


x  INTRODUCTION  TO  THE  AMERICAN  EDITION. 

of  the  tissue  involved,  and  the  degree  of  danger  to  life,  arising  out  of  the  nature  of 
the  respective  otHces  of  each  1 

remedial  need  in  tlie  treatment  of  Disease,  Dr.  Dickson  terms  Chrono-Ther- 
mal,  from  the  relation  which  their  influence  bean  to  Ztsss  Of  Period,  and  Tempera- 
ture, (cold  and  heat.)  ChroOM  being  the  Greek  word  for  Time,  and  Therma  for 
Heat  or  Temperature.  Theso  remedies  are  all  treated  of  hi  the  various  modern 
works  upon  the  Materia  Medica.  The  only  agents  this  6ystem  rejects,  are  "  the 
leech,  the  bleeding-lancet,  and  the  cupping  instrument." 

The  subject  of  blood-letting  occupies  a  considerable  portion  of  these  Lectures, 
author  to  perceive  its  dangers,  will  appear  in  the  following 
passage : — "  I  have  not  always  had  this  horror  of  blood-letting.  In  many  instances 
have  I  formerly  oaed  the  lancet,  where  a  cure,  in  my  present  state  of  knowledge, 
could  have  been  effected  without ;  but  this  was  in  my  noviciate,  influenced  by 
others,  and  without  sufficient  or  correct  data  to  think  for  myself.  In  the  Army  Hos- 
pitals I  had  an  opportunity  of  studying  disease,  both  at  home  and  abroad.  There  I 
saw  the  fine  tall  soldier,  on  his  first  admission,  bled  to  relief  of  a  symptom,  or  to 
faulting.  And  what  in  fainting.  A  loss  of  every  organic  perception — a  death-like 
6tate.  which  only  ditl'ers  from  iLath  by  the  possibility  of  a  recall.  Prolong  it  to 
permanency,  and  it  is  death.  Primary  symptoms  were  of  course  got  over  by  such 
measures ;  but  once  having  entered  the  hospital  walls,  I  found  that  soldier's  face 
become  familiar  to  me.  Seldom  did  his  pale  countenance  recover  its  former  healthy 
character.  He  became  the  victim  of  consumption,  dysentery,  or  dropsy  ;  his  con- 
stitution was  broken  by  the  first  depletory  measures  to  which  he  had  been  sub- 
jected." 

Our  author  objects  to  the  use  of  blood-letting,  for  this  best  of  reasons,   "  that  we 
have  remedies  without  number,  possessing  each  an  influence  equally  rapid,  and  an 
equally  curative,  without  being,  like  blood-letting,  attended  with  the  insu- 
perable disadvantage  of  abstracting  the  material   of  healthy  organization.     1  deny 
not  its  power  as  a  remedy  in  certain  cases,   but  1  question  its  claim  to  precedence 
even  in  these.    Out  of  upwards  of  twelve  thousand  <  tsesof  disease  that  have,  within 
the  last  few  years,  been  under  my  treatment,  I  have  not  been  compelled  to  use  it 
once.     Resorted  to  under  the  most  favourable  circumstances,  its  success  is  anything 
but  sure,  and  its  failure  involves  consequences  which  the  untoward  administration  of 
other  means  may  not  so  certainly  produce.     I  have  never  taken  credit  for  being  the 
first  opponent  of  the  Lancet.     But  one  thing  in  regard  to  this  mutter  I  do  claim  cre- 
dit for — I  claim  credit  for  being  the  first  man  who,  by  a  strong  array  of  facts,  and 
ducedan  impression  on  the  public,  that  all  the  facts  and 
all  the  arguments  of  former  opponents  of  the  lancet  never  before  produced  on  the 
on, — oamelj ,  an  impression  of  the  dangerousnature  of  the  remed]  ;  and  whe- 
ther they  like  to  lie  told  ol  it  or  imt,  1  claim  to  ha\e  either  convinced  or  compelled 
materially  to  alter  their  practice.     To  toy  blood-letting  is  a  bad  thing 
to  pri/ci  it  to  be  bad  is  another;  to  force  the  world  to  believe  and  act 
upon  your  arguments  against  it,  in  the   teeth  of  the   opinion  of  the  world,  is  a  still 
ichievement.     Thai  merit  1  distinctly  claim." 

Having  always  bad  a  repugnance  to  the  Letting  "f  blood,  the  practice  oJ  my  pro- 

Ungtothe  light  in  which  1  was  instn  luroeof 

great  dread — especially  in  the  treatment  of  acul  I  tee  an 

way  clearly— I  n-tie.l — I    revolted    from    a    System    of  pi.-ictice  ( 

niy  mi-  dd  not  give  its  full  and  entire  sanction.     In  that  ■ 

Dr.  Dickson's  work  \  mv   bands.     I  read  it  with  delight,  and  with  a 

tion  of  its  truth — a  conviction  which  time  and  experience  have  amply 

continued.     Borne  examples  of  the  results  of  this  experience  will  be  found  among 

the  lew  notes  1  1,  e.e  added  in  the  course  of  the  VI 


INTRODUCTION  TO  THE  AMERICAN  EDITION.  xi 

Disease  being  thus  simplified,  according  to  the  system  of  Dr.  Dickson,  it  follows 
that  it  is,  to  use  his  own  words,  amenable  to  a  Principle  of  treatment  equally  sim- 
ple. Partaking,  throughout  all  its  modifications,  of  the  nature  of  Ague,  it  will  be 
best  met  by  a  practice  in  accordance  with  the  proper  principle  of  treatment  of  that 
distemper.  To  apply  warmth,  or  administer  cordials  in  the  Cold  stage  ;  in  the  Hot, 
to  reduce  the  amount  of  temperature,  by  cold  affusion  and  fresh  air ;  or,  for  the  same 
purpose,  to  exhibit,  according  to  circumstances,  an  emetic,  a  purgative,  or  both  in  com- 
bination. \Vith  Quinine,  Arsenic,  Opium,  &c,  the  interval  of  comparative  health 
— the  period  of  medium  temperature — may  be  prolonged  to  an  indefinite  period ; 
and  in  that  manner  may  health  become  established  in  all  diseases — whether,  from 
some  special  local  development,  the  disorder  be  denominated  mania,  epilepsy,  croup, 
cynanche,  the  gout,  the  influenza !  In  the  early  stages  of  disease,  to  arrest  the  fever 
is,  in  most  instances,  sufficient  for  the  reduction  of  every  kind  of  local  develop- 
ment. A  few  rare  cases  excepted,  it  is  only  when  the  case  has  been  of  long  stand- 
ing and  habitual,  that  the  physician  will  be  compelled  to  call  to  his  aid  the  various 
local  measures  which  have  a  relation  to  the  greater  or  less  amount  of  the  tempera- 
ture of  particular  parts. 

Such  being  the  rational  and  intelligible  doctrines  of  the  Chrono-Thermal  System 
of  Medicine,  it  will  be  found  that  its  practice  is  equally  salutary  and  benign,  and 
that  its  chief  feature  is  to  make  short  work  of  disease.  As  an  instance  of  this,  I  will 
give  the  history  of  one  case  of  treatment  of  acute  disease,  without  blood-letting.  A 
lady  who  had  been  attending  an  evening  lecture  in  the  Tabernacle,  in  January,  was 
attacked  by  violent  chills,  followed  by  darting  pains  in  the  lungs,  severe  headache, 
a  rapid  pulse,  hurried  respiration,  and  all  the  symptoms  of  Inflammation  (so  called) 
of  the  Lungs.  Added  to  this,  owing  to  conpunctiou  in  having  gone  out  against  the 
advice  of  a  parent,  she  had  a  severe  nervous  or  hysterical  attack,  with  sobbing  and 
crying.  A  sharp  emetic  relieved  the  severity  of  all  the  symptoms  almost  at  once, 
and  an  opiate  brought  on  rest  and  repose  through  the  night.  Peruvian  Bark  and 
rest  were  the  chief  remedies  for  the  two  following  days.  On  the  third  day,  she 
was  well  enough  to  participate  with  the  family  at  meals  at  the  table ;  and  in  a  fort- 
night, notwithstanding  it  was  winter,  she  was  pronounced  strong  enough  and  well 
enough  to  go  out.  She  had  no  relapse,  but  has  continued  in  good  health  to  this  day. 
In  the  treatment  of'  diseases  of  children,  and  especially  of  those  of  females,  who 
are  more  liable  to  disorder,  owing  to  the  periodical  changes  peculiar  to  the  sex,  the 
Chrono-Thermal  System,  from  its  simplicity  and  efficacy,  will  be  found  to  be  parti- 
cularly valuable  and  eligible. 

Other  distinguishing  features  of  the  Chrono-Thermal  System  of  Medicine  are — 
First,  A  demonstration  of  the  fallacious  character  of  the  ideas  entertained  by  the 
Profession  and  the  Public  in  reference  to  Inflammation  and  Congestion,  those  fruit- 
ful sources  of  error.  Second,  that  Calomel  is  no  longer  placed  in  the  first  rank  of 
remedies  ;  and  when  given  is  prescribed  only  in  minute  doses,  as  fractions  of  a  grain. 
Third,  That  the-  Chrono-Thermal  Medicines  are  to  be  used  generally  in  minute 
doses,  and  that  hence  but  little  medicine  is  required.  Fourth,  The  doctrine  that  all 
remedies  act  primarily  upon  the  Brain,  and  thence,  electrically  or  magnetically, 
through  the  system. 

Writers  on  Medicine,  pursuing  a  false  mode  of  analysis,  have  for  a  long  time  been 
engaged  in  dividing  and  subdividing  the  subject  until  it  reached  its  acme  in  the  ela- 
borate and  ponderous  tomes  of  the  learned  and  classical  Dr.  Good  ;  in  which  such 
is  the  extent  of  subdivision  and  subtilty  attained  by  the  author,  that  the  recollection 
of  the  mere  names  of  the  various  diseases  as  classified,  would  be  a  severe  trial  to  a 
memory  of  ordinary  tenacity.  At  this  period,  Dr.  Dickson  arose,  and  seizing  upon 
the  question  with  the  true  analytical  grasp  of  his  genius,  reduced  the  whole  to  a 


xii  INTRODUCTION  TO  THE  AMERICAN  EDITION. 

system  of  simplicity.  So  that  a  complete,  highly  scientific,  and  rational  doctrine 
of  disease  and  its  treatment  is  embraced  in  the  small  volume  which  the  reader  holds 
in  his  hands.  Some  unprofessional  readers,  in  taking  up  this  book,  may  possibly 
think,  from  its  subject,  that  it  is  a  dull,  dry,  and  tedious  disquisition  upon  matters 
of  interest  to  the  medical  fraternity  alone.  This  would  be  a  great  error.  The  au- 
thor has  adapted  it  to  popular  use ;  on  which  account,  he  has  discarded  as  much  as 
possible  all  technical  terms.  He  has  also  enlivened  his  production  by  the  introduc- 
tion of  apt  facts  and  incidents,  and  pertinent  arguments  and  illustrations ;  so  that, 
instead  of  being  dull,  dry,  and  tedious,  the  reader  will  find  it  eminently  sprightly, 
amusing,  and  instructive. 

Scattered  throughout  the  work  will  be  met  with,  testimony  by  distinguished  Phy- 
sicians and  Surgeons  of  Great  Britain  in  favour  of  the  system  of  Dr.  Dickson;  among 
the  rest,  a  letter  from  Sir  Astley  Cooper,  who,  on  receiving  a  copy  of  a  previous  edi 
tion,  under  the  title  of  the  "  Unity  of  Disease,"  sent  an  answer,  in  which  he  styled  it 
a  "  valuable  work."  It  will  be  noticed,  too,  that  the  work  has  been  translated  into 
French,  German,  and  Swedish,  for  the  use  of  the  people  of  those  nations. 

Wm.  Turner. 

New  York,  2C9  Tenth  Street. 


P.  S.  While  this  reprint  was  passing  through  the  press,  the  April  steamer  arrived, 
bringing  copies  of  several  new  medical  works  from  the  London  publishers.  Among 
them  were  two  books,  fresh  from  the  London  press,  which,  as  they  are  corrobora- 
tive of  the  truth  of  the  Chrono-Thermal  System,  and  indicative  of  the  progress  that 
benign  and  salutary  system  is  making  among  active  and  scientific  minds  in  the  Bri- 
tish metropolis,  I  have  thought  it  would  not  be  unprofitable  to  devote  a  little  extra 
space  to  their  examination. 

The  first,  entitled  Practical  Observations  on  the  Diseases  most  fatal  to  Children,  is 
by  Mr.  Hood.  The  chief  object  of  this  gentleman's  work,  is  to  call  the  attention, 
not  of  medical  men  only,  but  of  all  persons  who  may  be  interested  in  the  matter, 
to  tli.-  investigation  of  the  mode  of  treatment  which  may  be  most  appropriate  in  the 
■  rious  diseases  of  children.  "  The  treat ment  generally  adapted.-'  he  adds, 
"in  in-.:  t  of  those  diseases  where  they  are  severe,  and  mora  especially  in  such  of 
th.  i.i  as  affect  the  organs  of  respiration,  is  founded  on  the  opinion,    that  they  either 

proceed  from,  or  resolve  themselves into  iflflammation;  ami  that  this  so-called  in- 
flammation, if  not  properly  checked  by  bleeding  and  the  administration  of  active 
antiphlogistic  medicines,  speedily  causes  death.      Now,"  In-  proceeds,  "  without  en- 
lure  into  any  pathological  discussion  respecting  the  symptoms  and  conse- 
of  Inflammation,  but  supposing  that  it  exists,  or  is  to  be  apprehended  in 
referred  to,  il  may  yd  be  cenAdetnfy  affirmed,  on  evidence  mi 
by  the  Reports  of  the  thai  the  mode  of  treatment  above  men- 

tioned is  improper."    Aftei  i  instructed  from  that  report, 

i  -  is  follows:— "The  mode  of  treatment  developed  iutho  following  pages 

led  on  the  principle,  that  the  diseasi  -   >f  children,  and  of  adult-  also,  p 

ml  sens,',  as  distinct  from  inflammation,  and  bv 
,,  lie. pi. -nil;,  witnessed  thi 
cial  efl  i  te  of  treatment,  nol  onlj  in  the  ffssssni  of  children  exp 

ted  in  the  following  pages,  but  in  others  also,  s/hether  occurring  in  children 

or  adults,  1  have  ventured  to  publish  the  prasenl  work*  with  the  view  of  calling  the 

on  of  both  medical  practitioD  .I  '"-•" 


INTRODUCTION  TO  THE  AMERICAN  EDITION.  xiii 

The  subjects  treated  of  are  inflammation,  irritation,  teething,  bronchitis,  and  inflam- 
mation of  the  lungs,  whooping-cough,  croup,  measles,  scarlet-fever,  small-pox,  con- 
vulsions, and  inflammation  of  the  brain,  scrofula  and  cachectic  diseases,  constipation, 
and,  lastly,  the  effects  of  calomel  on  children.  Under  the  head  of  inflammation  of 
the  lungs,  he  says,  "  I  do  not  hesitate  to  declare,  that  the  great  mortality  of  young 
children,  from  this  particular  affection,  arises  chiefly  from  the  attempts  made  to  sub- 
due the  disease  by  abstraction  of  (lie  blood."  In  discussing  inflammation  on  the  brain, 
he  remarks,  "  In  looking  over  several  cases  which  I  have  known  treated  by  bleeding 
or  leeches,  when  the  brain  was  suffering  from  congestion  in  infants,  I  am  unable  to 
point  out  one  in  which  the  treatment  was  successful.  There  was  usually  an  abate- 
ment in  the  violence  of  the  symptoms  for  a,short  period  when  blood  had  been  drawn, 
but  they  invariably  returned  with  redoubled  vigour ;  and  death  appeared  to  be  has- 
tened by  the  use  of  blood-letting  as  a  remedy." 

The  other  work  is  entitled,  "  A  Collection  of  Cases  of  Apoplexy,  with  an  Explana- 
tory Introduction.  By  Edward  Copeman,  Surgeon."  The  author  has  transcribed 
from  various  authentic  works  and  journals,  and  from  his  own  note-book,  no  less  than 
250  cases  of  Apoplexy,  in  order  to  convince  himself  of  the  correctness  of  an  opinion 
he  had  long  entertained,  that  the  popular  and  professional  prejudice  in  favour  of 
bleeding  in  affections  of  the  brain,  is  not  justifiable  by  the  results  of  the  practice. 
The  following  is  the  conclusion  at  which  he  has  arrived  : — "  A  comparison  of  the 
success  attending  the  practice  of  bleeding  in  Apoplexy  with  that  where  bleeding 
was  not  employed,  as  shown  by  the  following  cases,  is  decidedly  in  favour  of  the 
latter ;  and  should  be  considered  sufficiently  correct,  from  the  number  of  cases  re- 
ported, to  neutralize  the  far  too  prevalent  idea  that  bleeding  is  the  only  remedy  to  be 
depended  on  in  Apoplexy.  The  practice  of  giving  Emetics  when  the  attack  has 
succeeded  a  full  meal,  has  not  only  been  safe,  but  effectual.  In  cases  occurring  in 
old  age,  Brandy  and  other  stimulants  have  restored  animation  and  removed  the  Apo- 
plexy. Purgatives  have  always  been  acknowledged  to  be  of  essential  service  in 
most  cases  that  have  recovered.  The  appbcation  of  cold  to  the  head,  sinapisms  to 
the  lower  extremities,  warm  pediluvia,  and  vesications,  have  each  in  their  turn  ap- 
peared to  be  useful ;  and  are,  at  all  events,  free  from  the  objections  that  they  can 
either  produce  or  add  to  the  mischief.  I  would,  therefore,  strongly  urge  those  who 
may  take  the  trouble  to  examine  the  following  collection  of  cases,  to  dismiss  from 
their  minds  all  the  notions  which  their  experience  does  not  justify ;  and  henceforth 
to  treat  Apoplexy  on  the  same  scientific  and  rational  principles  (?)  that  guide  their 
practice  in  other  cases."  The  following  are  tables  of  the  cases  above  alluded  to : — 
Number  not  bled,  26,  cured,  18,  died,  8. 

Number  bled,  129,  *  51.  "  78. 

Number  of  cases  in  which  the  treatment  is  specified,  155. 

Proportion  of  Cures  in  caseB  treated  by  Bleeding 1  in  9J. 

Proportion  of  Deatlis  in  ditto,  about 1  in  1}. 

Proportion  of  Cures  in  Cases  not  bled, 1  in  li. 

Proportion  of  Deaths  in  ditto, 1  in  3J. 

Behold,  then,  the  answer  to  the  question  which,  above  all  others,  is  asked  by  tho 
devotees  of  the  Old  School  of  Medicine : — '  If  blood-letting  is  to  be  prohibited  in 
all  cases  of  Disease,  what  in  the  world  is  to  be  done  in  Apoplexy?' 

*       W.  T. 


PREFACE  TO  THE  SECOND  AMERICAN  EDITION. 


"Like  causes,"  philosophers  assure  us,  "produce  like  effects."  The  reader, 
therefore,  will  be  prepared  to  hear  that  the  appearance  three  years  ago  of  this  work 
in  this  city,  created  as  great  an  uproar  in  the  medical  camp  on  this  side  the  Atlantic, 
as  that  so  pungently  described  by  Dr.  Dickson  as  having  occurred  on  the  other  side. 
The  confusion  that  arose  at  Brussels  on  the  night  before  the  battle  of  Waterloo, 
might  faintly  give  an  idea  of  the  "  running  to  and  fro,  the  mounting  in  hot  haste," 
with  which  the  fraternity  here  were  agitated.  The  professional  organ,  speechless 
for  four  months,  at  last  found  vent  for  its  "  wrath  and  cabbage,"  in  an  article  brim- 
ful of  contempt,  impertinence,  meanness  and  falsehood.  The  following  defence  of 
the  lancet  is  embalmed  from  it  for  future  reference : — 

"  That  a  mode  of  treatment,  (blood-letting,)  that  has  been  in  use  from  the  most 
.pemote  antiquity;  that  has,  as  it  were,  by  intuition  or  instinct,  been  employed  by 
uncivilized  nations  for  the  relief  of  various  maladies  ;  whose  benefits  have  been  ac- 
knowledged by  all  medical  writers,  and  all  accurate  observers  in  every  age;  which 
still  maintains  its  ground  against  the  cavils  of  the  interested  and  the  prejudice!  of 
the  ignorant;  a  remedy  to  which  many  are  often  compelled  to  resort,  even  in  oppo- 
sition to  their  theoretical  views,  and  the  principles  of  the  medical  systems  they  have 
adopted, — that  such  a  remedy  is  now  to  be  cried  down  and  banished  from  the 
world  by  such  books  as  this,  is  about  as  probable  as  that  sickness  itself  is  about  to 
disappear  from  the  earth." 

In  November,  184G,  I  was  suddenly  called  to  a  patient  in  apoplexy,  surrounded 
by  a  crowd,  and  who  proved  to  be  himself  a  physician,  who  had  been  a  professor 
in  several  medical  institutions.  The  cold  dash  brought  him  to  his  feet  in  ten  mi- 
nutes. The  promptness  of  the  relief,  and  the  simplicity  of  the  means,  caused  a  great 
sensation ;  and  the  subject  found  its  way  into  the  newspapers,  whereupon  the  pro- 
fession had  another  violent  spasm.  What  was  now  to  be  done  ?  The  majesty  of 
the  lancet,  in  so  formidable  a  disease  as  apoplexy,  was  not  only  invaded,  but  actually 
overthrown !  What  would  Mrs.  Grundy  (the  people)  say,  at  the  exposure  ?  Alci- 
biades,  to  divert  public  attention  from  his  misconduct,  cut  off  his  dog's  tail,  and  sent 
him  howling  through  the  etreeta.  Napoleon,  to  stop  the  gossip  of  Paris  after 
the  defeat  at  Moscow,  commanded  the  gilding  of  the  dome  of  the  Iuvalides. 
While,  to  complete  the  climax,  Sangrado  id  New  York,  stung  with  a  sudden  and  un- 
expected defeat,  and  not  to  be  outdone  in  the  game  of  playing  cuttle-fish,  established 
an  Academy  of  Medicine,  to  declare,  with  exemplary  impartiabty,  every  body  a 
quack  but  himself.  Unfortunately  for  him — quem  Deus  vult  perdere  prius  dements! 
— this  body  in  November  last  celebrated  its  first  anniversary  with  a  grand  pow-wow 
at  the  Tabernacle,  when,  in  a  long  address,  the  President  (Dr.  Fraiu  is)  made  the 
following  declaration,  which  was  published  by  order  of  tho  Academy : — 

"  There  aiw  severed  remarkMr  forms  of  disease,  whose  periodical  prevalence  is  the 
occasion  of  great  mortality,  which  have  aol  yet  received  the  attention  their  importance 
deserves.     Few  maladies  committed  to  the  charge  of  tin-  medical  preaoriber  are  of 
deeper  interest  than  the  cholera  infantum  [summer  complaint  |  of  our  snmmi 
Aontt.    We  may  look  in  vain  for  anything  satisfactory  on  the  subject  in  the  works  of 


PREEACE    TO    THE    SECOND    AMERICAN    EDITION.  XV 

European  writers.  It  were  almost  criminal  not  to  make  further  efforts  to  ascertain 
the  pathology  of  this  most  fatal  disorder,  which  ravages  infantile  life,  and  bring  to  the 
test  of  experimental  decision  improved  practical  measures." 

Need  we  wonder  after  this  public  confession  of  igdorance  in  behalf  of  the  faculty, 
that  the  City  Inspector's  report  for  1847,  should  announce  the  deaths  of  children 
under  five  years  of  age  at  7,373,  or  nearly  one-half  of  the  whole  ?  Which  member 
of  the  Academy,  having  his  watch  to  be  repaired,  would  send  it  to  one  who  acknow- 
ledged he  knew  nothing  of  the  nature  of  injuries  to  watches  1  Yet  parents  are  ex- 
pected to  be  more  heedless  of  their  precious  children,  than  of  a  paltry  bauble  !  My 
"  Triumphs  of  Young  Physic,"  published  a  year  ago,  contained  proofs  to  those  not 
wilfully  blind,  that  at  least  one  European  writer  (Dr.  Dickson)  could  be  relied  on 
for  something  "  satisfactory  on  the  subject."  I  select  from  a  letter  from  the  late 
venerable  Dr.  Marsh  of  New  Jersey,  the  following  : — 

•'In  the  case  of  a  child  about  two  years  old,  with  colliquative  diarrhoea,  (usually 
termed  summer  complaint,)  and  which  had  become  much  emaciated  from  disease, 
("added  to  the  bold  mercurial  cathartic  practice  which  had  been  pursued  in  the  case  J 
I  prescribed  minute  doses  of  Dickson's  remedies.  The  effect  was  a  complete  cure 
in  two  days.  The  child  is  now  healthy  and  cheerful,  and  I  am  constrained  to 
believe  that  had  this  treatment  not  been  adopted,  the  parents  would  now  be 
mourning  for  it,  as  they  have  done  for  four  others  they  have  lost  with  the  same 
disease." 

The  following  incident  shows  that  some  of  the  profession  can  rival  Ancient  Pistol 
in  the  faculty  of  eating  and  swearing.  It  is  from  the  lips  of  a  friend  doing  business 
in  Wall  street.  "  What  I  admire,  doctor,"  said  he,  "  is  the  coolness  with  which  old 
practitioners  adopt  your  system,  while  they  affect  to  condemn  it.  After  perusing 
your  book,  I  lent  it  to  my  physician.  Last  winter  I  had  a  dangerous  and  violent 
attack  of  ship-fever.  The  treatment  was  vigorous,  prompt,  and  successful.  When 
well  enough  I  asked  my  physician  whether  he  had  not  taken  a  leaf  out  of  your  book  ? 
1  Not  at  all,'  replied  he.  '  Did  you  know  this  mode  five  years  ago  ?'  I  asked.  '  I 
knew  it  before  I  was  born!'  he  rejoined.  '  Well,  then,  if  you  knew  it  before  you 
were  born,  how  happens  it  you  did  not  practice  the  same  with  two  of  my  children, 
who,  within  five  years,  have  been  down  in  a  manner  similar  to  myself,  and  were 
saved  with  the  greatest  difficulty  V     The  .doctor  was  silent !" 

Several  important  discoveries  have  been  made  within  the  past  year.  One  by  Dr. 
Brigham,  of  the  Utica  Lunatic  Asylum,  that  blood-letting  is  pernicious  in  lunacy. 
Another  by  Dr.  Keese,  of  the  Bellevue  Hospital,  of  the  value  of  stimulants  in  ship- 
fever.  While  Professor  Dickson,  of  this  city,  is  alleged  to  have  made  considerable 
progress  in  the  investigation  of  the  periodicity  of  disease.  But  no  thanks  in  either 
case  to  the  rightful  Dr.  Dickson,  whose  sin  as  first  discoverer  is  unpardonable. 

From  the  many  letters  I  have  received  from  various  parts  of  the  country,  1  select 
one  (see  appendix,  page  221 )  from  a  physician  in  a  city  at  the  South,  as  being  the 
most  comprehensive.  The  name  of  the  writer  is  suppressed  for  the  present,  from 
the  apprehension  he  entertains  of  persecution  on  the  part  of  his  medical  neighbors. 
What  a  biting  sarcasm  upon  our  inflated  pretensions  to  freedom  of  opinion  in  tho 
"  land  of  the  free,  and  the  home  of  the  brave !" 


SKETCH  OF  DR.  DICKSON. 

Samuel  Dickson  was  born  at  Edinburgh,  on  the  26th  of  April,  1802.  He  was  the 
eldest  of  live  children,  and,  like  liis  father,  was  bred  to  the  law*  Bat,  being  of  i 
philosophic  and  inquiring  turn,  he  took  an  early  disgnst  to  this  profession,  and.  for 
tunately  for  mankind,  ho  choee  medicine  as  the  field  of  his  future  studies.  In  1825, 
h«'  gol  liis  diploma  from  tin;  Edinburgh  College  of  Surgeons;  and  carried  off  the 
p. Id  medal  for  the  beal  essay  on  tin-  ••  Fi  od  of  Plants,"  at  the  university  of  that  city. 
After  studying  a  few  months  in  Pari?,  he  obtained  his  commission  as  a  medical  officer 
iu  the  army,  in  which  capacity  he  served  with  distinction  both  at  home  and  abroad, 
particularly  in  India,  where  he  bad  an  opportunity  of  making  himself  well  acquain- 
ted with  tropical  diseases.  On  his  return,  he  published  his  work  on  the  diseases  of 
India.  In  1332,  he  married  ••  the  beauty  of  Edinburgh,"  Miss  Eliza  Job 
daughter  of  David  Johnston,  Es<].,  of  Overton,  and  neice  of  Lord  Campbell,  formerly 
Lord  High  Chancellor  of  Ireland.  Soon  after,  he  took  his  degree  of  M.  D.  at 
gow,  and,  in  1833,  he  left  the  army  and  settled  in  Cheltenham.  For  the  first  two 
years  his  success  was  unprecedented.  In  that  short  period,  he  prescribed  for  up- 
wards of  7000  patients.  His  door  became  literally  besieged;  and  this,  as  a  matter 
of  coarse,  drew  down  upon  him  the  malice  of  the  profession.      But  "  water  rises  by 

firessure,"  and,  in  the  end,  true  courage,  true  genius,  aud  true  worth,  will  do  the  same, 
n  1836'.  undaunted  by  the  wicked  machinations  of  his  professional  enemies,  he 
published  the  secret  of  his  amazing  popularity,  his  first  sketch  of  the  Chrono-Ther- 
mal  system  of  medicine,  under  the  bold  and  fearless  title  of  "  The  Fallacy  of  the 
Ait  of  Physic  as  taught  in  the  schools,  with  new  and  important  principles  of  prac- 
tice," which  certainly  proposed  a  complete  revolution  in  medical  theory  ami  practise. 
In  1838,  he  again  brought  out  his  new  doctrine  in  "  The  Unity  of  Disease."     In 

1839,  he  left  "Cheltenham  for  London,  having  received  a  pieoe  of  plate  of  fifty 
guineas'  value,  as  a  testimony  to  his  merits,  from  the  people  of  the  former  town.    In 

1840,  he  delivered  his  lectures  on  the  "  Fallacies  of  the  Faculty,  and  the  Chrouo- 
Thermal  System  of  Medicine," — a  system  which  the  profession,  with  a  few  honor- 
able exceptions,  did  their  utmost  to  crush;  but,  failing  in  the  attempt,  they  have 
been  since,  in  consequence,  compelled  to  modify  their  practice  according  to  the 
precepts  of  the  great  master  ;  thus  giving  a  practical,  and  therefore  the  best 

ble  testimony  to  the  accuracy  of  his  system. 

Dr.  Dickson  is  of  middle  stature,  dark  hair,  and  penetrating  eyes.   His  Features  are 
peculiarly  expressive,  and  strongly  indicative  of  great  powers  of  perception  and 
concentration,  united  with  firmness  and  determination.     His  habits  are  quiet  antl 
unobtrusive,  his  manners  courteous  and  unassuming.     Ills  temper  is  quick,  but 
''  Ho  carries  anger  as  the  flint  boars  fire, 
Which,  much  enforced,  yield*  u  hasty  spark, 
And  straight  is  cold  again." 

Some  of  his  professional  enemies,  by  purloining  his  ideas,  (and  language,  too,)  have 
basely  endeavored  to  nob  him  of  that  merit  to  which  he  is  entitled:  others  have  in- 
sidiously tried  to  damn  his  reputation,  hut  he  has  made  their  evil  efforts  recoil  upon 
themselves.      He  has  slain   every  serpent    that    has  CTOSSed   his   path,  so   that    those 

who  offer  him  the  first  blow  musl  be  prepared  to  receive  the  last.   Notwithstanding 

this,  he  is  open-hearted  ami  generOUS,  over  ready  with  his  s-rvices,  and  was  never 
known  to  take  a  fos  from  any  one  to  whom  he  thought  that  fee  would  be  an  object 

llis  practice  in  Cheltenham  and  the  surrounding  neighborhood  was  alike  exti 

»and  successful,  and  for  some  time  prior  to  hie  departure  for  London,  the  number  of 

tients  who  sought  and  received  relief  at  his  hands  could  not  be  loss  than  one  f 

dreda-day!     liis  praise  was  the  theme  of  every  tongue,  while  diseases,  hitht 

incurable,  vanished  before  the  magic  of  his  uhrono-Therma]  wand. 

•i  his  raccesa  has  been  equally  signal.     How  far  he  may  have  profited  by  hi* 

relationship  to  a  Minister  of  tin-  Grown,  we  have  not  the  means  of  knowing, 

but  his  enemies  are  wrong  when  they  pretend  that  In-  owes  all  to  that  quarter, 

Dr.  Diokson  had  a  great  reputation  before  ho  married  the  niece  of   Lord  ('amphell. 


msive 

% 


THE 

CHRO  NO-THERMAL 

SYSTEM  OF  MEDICINE. 


LECTURE     I. 

introduction phenomena   of   health   and   sleep disease  and 

its  type causes. 

Gentlemen, 

We  daily  hear  of  the  march  of  intellect,  of  the  progress 
or  perfection  of  many  branches  of  science.  Has  Medicine  kept  pace  with 
the  other  arts  of  life — has  it  fallen  short  or  excelled  them  in  the  rivalry  of 
improvement  ?  Satisfactorily  to  solve  this  question,  we  must  look  a  little 
•  deeper  than  the  surface — for  Truth,  as  the  ancients  said,  lies  in  a  well, — 
meaning  thereby  that  few  people  are  deep-sighted  enough  to  find  it  out.  In 
the  case  of  Medicine,  we  must  neither  be  mystified  by  the  boasting  asser- 
tions of  disingenuous  teachers,  nor  suffer  ourselves  to  be  misled  by  the  medical 
press  ;  the  conductors  of  which,  for  the  most  part,  are  the  mere  hirelings  of 
party,  their  principal  business  being  to  crush  and  cry  down  such  truths  or 
discoveries  as  may  chance  to  militate  against  the  interests  of  the  schools  and 
coteries  they  are  employed  to  serve.  The  late  Sir  William  Knighton  was  at 
the  head  of  his  profession ;  he  was,  moreover,  physician  to  George  the 
Fourth.  Joining,  as  he  did,  much  worldly  wisdom  and  sagacity  to  a  compe- 
tent knowledge  of  the  medical  science  of  his  age,  his  opinion  of  the  state  of 
our  art  in  these  days  may  be  worth  your  knowing ;  more  especially  as  it  was 
given  in  private,  and  at  a  time  when  he  had  ceased  to  be  pecuniarily  inter- 
ested in  its  practice.  In  a  letter  to  a  friend,  published  after  his  death,  he 
thus  delivers  himself: — "  It  is  somewhat  strange  that,  though  in  many  arts 
and  sciences  improvement  has  advanced  in  a  step  of  regular  progression  from 
the  first,  in  others  it  has  kept  no  pace  with  time ;  and  we  look  back  to  ancient 
excellence  with  wonder  not  unmixed  with  awe.  Medicine  seems  to  be  one 
of  those  ill-fated  arts,  whose  improvement  bears  no  proportion  to  its  antiquity. 
This  is  lamentably  true,  although  Anatomy  has  been  better  illustrated,  the 
Materia  Medica  enlarged,  and  Chemistry  better  understood."  Dr.  James 
Gregory,  a  man  accomplished  in  all  the  science  and  literature  of  his  time, 
wasfor  many  years  the  leading  physician  of  Edinburgh;  but  he  nevertheless 
held  his  profession  in  contempt.  On  visiting  London,  he  had  an  opportunity 
of  being  introduced  to  his  equally  celebrated  countryman  Baillie.  Curious' 
to  know  Gregory's  opinion  of  the  man  who  then  swayed  the  medical  sceptre 
of   the  metropolis,   his  friends   asked   him   what  he  thought  of   Baillie. 


18  LECTURE  I. 

"  Baillie,"  he  replied,  "  knows  nothing  but  Physic  ;"  in  revenge  for  which, 
Baillie  afterwards  wittily  rejoined,  "Gregory  knows  everything  but  Phytic."' 
But  what  was  Dr.  Baillie's  own  opinion  of  his  art,  after  all  ?  I  do  not  allude 
to  his  language  during  the  many  years  he  was  in  full  practice  ;  then,  doubt- 
less, with  the  multitude  who  thronged  his  door,  he  really  believed  he  knew  a 
great  deal ;  but  what  did  he  say  when  he  retired  from  his  profession,  and 
settled  at  his  country-seat  in  Gloucestershire  1  Then,  gentlemen,  without 
the  slightest  hesitation,  he  declared  he  had  no  faith  in  Physic  whatever ! 
But,  you  must  not  from  this  imagine  that  the  fortunate  doctor  intended  to 
say  that  the  world  had  all  along  been  dreaming  when  it  believed  Opium  could 
produce  sleep,  Mercury  salivate,  and  Rhubarb  purge.  No  such  thing:  he 
only  confessed  that  he  knew  nothing  of  the  manner  of  action  of  these  sub- 
stances on  the  body,  nor  the  principle  upon  which  they  should  be  used. 
Now,  what  would  you  think  of  a  sailor  who  had  expressed  himself  in  the 
same  way,  in  regard  to  the  rudder  and  compass, — who  had  told  you  that  he 
had  no  faith  in  either  instrument  as  a  guide  to  steer  a  vessel  by  ?  Why, 
certainly,  that  he  knew  nothing  of  the  profession  by  which  he  gained  his  liv- 
ing. And  such  really  was  Dr.  Baillie's  case.  The  great  bulk  of  mankind 
measure  the  professional  abilities  of  individuals  solely  by  their  degree  of 
reputation — forgetting  Shakspcare's  remark,  that  a  name  is  very  often  got 
without  merit  and  lost  without  a  fault.  That  Baillie  actually  attained  to  the 
eminence  he  did,  without  any  very  great  desert  of  his,  what  better  proof 
than  his  own  declaration  ? — a  declaration  which  fully  bears  out  what  Johnson 
tells  us  in  his  life  of  Akenside : — "A  physician  in  a  great  city  seems  to  be 
the  mere  plaything  of  fortune  :  his  degree  of  reputation  is  for  the  most  part 
totally  casual ;  they  that  employ  him  know  not  his  excellence — they  that 
reject  him  know  not  his  deficiency."  But  still,  some  of  you  may  very  natu- 
rally ask,  How  could  Dr.  Baillie,  in  such  a  blissful  state  of  ignorance  or 
uncertainty,  contrive  to  preserve  for  so  long  a  period  his  high  position  with 
the  professional  public  ?  This  I  take  to  be  the  true  answer  : — The  medical 
art,  like  every  other  art,  must  have  had  its  infancy — a  period  when,  knowing 
nothing,  its  professors  may  fairly  be  excused  for  believing  anything.  When 
Baillie  began  practice,  the  profession  were  slowly  and  timidly  groping  their 
way  in  the  gloom  :  a  few  practical  points  they  of  course  knew  :  but  of  the 
true  principle  of  the  application  of  those  points,  they  were,  as  I  shall  after- 
wards show  you,  entirely  ignorant.  Most  of  them  were,  therefore,  very 
ready  to  follow  any  one  of  their  OAvn  number  who  should  most  lustily  cry 
out,  Eureka — I  have  found  it  !  In  the  dark  wo  mistake  a  pigmy  for  a 
giant,  the  more  especially  if  he  talks  grandiloquently.  That  was  what  Dr. 
Baillie  did.  At  the  commencement  of  his  career,  few  medical  men  opened 
the  bodies  of  their  dead  patients;  for  Sydenham,  the  English  Hippocrates, 
had  long  before  ridiculed  tin;  practice.  It  was,  therefore,  all  but  in  disuse, 
and  all  but  forgotten,  when  Dr.  Baillie  published  his  book  on  Morbid  Anato- 
my,— a  book  wherein,  with  a  praiseworthy  minuteness  and  assiduity,  he  de- 
tailed a  great  many  of  the  curious  appearances  so  usually  found  in  the  dis- 
section of  dead  bodies.  Had  he  stopped  here,  Dr.  Baillie  would  have  dune 
Medicine  some  little  service;  but  by  doing  more  lie  accomplished  less — more 
for  himself,  less  for  the  public  :  for  by  further  teaching  that  the  only  way  to 
learn  the  cure  of  the  living  is  to  dissect  the  bodies  of  the  dead,  he  put  the 
profession  on  a  wrong  path, — one  from  which  it  will  be  long  before  the  nil* 
thinking  majority  can  in  all  likelihood  be  easily  reclaimed.  In  the  earlier 
part  of  his  career,  Dr.  Baillie,  it.  is  only  fair  to  suppose,  bettered  what  he 
wrote,  though  by  his  after  declaration,  he  admitted  himself  wrong.  Hi'* 
arguments,  nevertheless,  succeeded  bul  too  well  with  the  profession;  proving 
the  truth  of  Savage  Landor's  observation,  that  "in  the  intellectual  as  in  the 
•physical,  men  grasp  you  firmly  and  tenaciously  by  the  hand,  creepin 
at  your  side,  step  by  step,  while  you  lead  them  into  dnrlwn  -s.  but  when  you 
lead  them  into  sudden  light,  they  start  and  quit  you  !"     To  impose  upon  "the 


LECTURE  I.  19 

world  is  to  secure  your  fortune ;  to  tell  it  a  truth  it  did  not  know  before,  is  to 
make  your  ruin  equally  sure.  How  was  the  exposition  of  the  Circulation 
of  the  Blood  first  received  ?  Harvey,  its  discoverer,  was  persecuted  through 
life  ;  his  enemies  in  derision  styled  him  the  Circulator, — a  word  in  its  original 
Latin  signifying  vagabond  or  quack  ;  and  their  efforts  to  destroy  him  were  so 
far  successful,  that  he  lost  the  greater  part  of  his  practice  through  their  united 
machinations.  "  Morbi  non  eloquentia  sed  remediis  curantur"  is  an  observa- 
tion some  of  you  may  have  met  in  Celsus,  which,  if  you  will  allow  me,  I 
will  translate  : — Diseases  are  cured  by  Remedies,  not  by  Wrangling.  Yet, 
strange  to  say,  the  generality  of  great  professors  who  have  successively  ob- 
tained the  public  ear  since  the  time  of  the  Roman  physician,  have  been 
almost  all  as  remarkable  for  their  love  of  disputation  as  they  have  been  in- 
veterate against  every  thing  savouring  of  innovation  in  the  shape  of  remedies. 
When  a  limb  is  amputated,  to  prevent  the  patient  bleeding  to  death,  you  tie 
the  arteries.  Before  the  time  of  Francis  the  First,  surgeons  followed  another 
fashion  :  they  staunched  the  blood  by  the  application  of  boiling  pitch  to  the 
surface  of  the  stump.  Ambrose  Bare,  principal  surgeon  to  that  king,  intro- 
duced the  ligature  as  a  substitute — he  first  tied  the  arteries.  Mark  the  re- 
ward of  Ambrose  Pare  :  he  was  hooted  and  howled  down  by  the  Faculty  of 
Physic,  who  ridiculed  the  idea  of  hanging  human  life  upon  a  thread,  when 
boiling  pitch  had  stood  the  test  of  centuries.  In  vain  he  pleaded  the  agony 
of  the  old  application ;  in  vain  he  showed  the  success  of  the  ligature.  Cor- 
porations, colleges,  or  coteries  of  whatsoever  kind,  seldom  forgive  merit  in  an 
adversary  ;  they  continued  to  persecute  him  with  the  most  remorseless  ran- 
cour :  but  Pare  had  a  spirit  to  despise  and  a  master  to  protect  him  against  all 
the  efforts  of  their  malice.  What  physician  now-a-days  would  dispute  the 
value  of  antimony  as  a  medicine  1  No  one  with  a  grain  of  sense  in  his  head. 
Yet,  when  first  introduced,  its  employment  was  voted  a  crime.  Perhaps 
there  was  a  reason  !  Oh,  certainly  !  it  was  introduced  by  Paracelsus — Para- 
celsus, the  arch-enemy  of  the  established  practice.  At  the  instigation  of  the 
college,  the  French  parliament  accordingly  passed  an  act  making  it  penal  to 
prescribe  antimony.  To  the  Jesuits  of  Peru,  Protestant  England  owes  the 
invaluable  bark ;  how  did  Protestant  England  first  receive  this  gift  of  the 
Jesuits  ?  Being  a  popish  remedy,  they  at  once  rejected  the  drug  as  the  in- 
vention of  the  father  of  all  papists — the  devil.  For  the  same  reason,  possi- 
bly, the  physicians  of  Frederick  the  Great  dissuaded  him  from  trying  it  to 
cure  his  ague :  luckily  for  the  King,  he  laughed  at  their  advice,  took  bark, 
and  got  well.  In  1693,  Dr.  Groenvelt  discovered  the  curative  power  of 
Cantharides  in  dropsy  ;  what  an  excellent  thing  for  Dr.  Groenvelt ! — Excel- 
lent indeed  :  for  ho  sooner  did  his  cures  begin  to  make  a  noise  than  he  was  at 
once  committed  to  Newgate,  by  warrant  of  the  president  of  the  College  of 
Physicians,  for  prescribing  cantharides  internally.  Blush !  most  sapient 
College  of  Physicians — your  late  president,  Sir  Henry  Halford,  was  a  hum- 
ble imitator  of  the  ruined  Groenvelt !  Before  the  discovery  of  vaccination, 
Inoculation  for  Small  Pox  was  found  greatly  to  mitigate  that  terrible  disease. 
Who  first  introduced  small  pox  inoculation  ?  Lady  Mary  Montague,  who 
had  seen  its  success  in  Turkey.  Happy  Lady  Mary  Montague !  Rank, 
sex,  beauty,  genius — these  all  doubtless  conspired  to  bring  the  practice  into 
notice.  Listen  to  Lord  Wharncliffe,  who  has  written  her  life,  and  learn 
from  his  story  this  terrible  truth — that  persecution  ever  has  been,  and  ever 
will  be,  the  only  reward  of  the  benefactors  of  the  human  race.  "  Lady 
Mary,"  says  his  Lordship,  "  protested  that  in  the  four  or  five  years  immedi- 
ately succeeding  her  arrival  at  home,  she  seldom  passed  a  day  without  re- 
penting of  her  patriotic  undertaking ;  and  she  vowed  she  never  would  have 
attempted  it  if  she  had  foreseen  the  vexation,  the  persecution,  and  even  the 
obloquy  it  brought  upon  her.  The  clamours  raised  against  the  practice,  and 
of  course  against  her,  were  beyond  belief.  The  faculty  all  rose  in  arms  to  a 
man,  foretelling  failure  and  the  most  disastrous  consequences ;  the  clergy 


20  LECTURE!. 

descanted  from  their  pulpits  on  the  impiety  of  thtis  seeking  to  take  events 
out  of  the  hands  of  Providence ;  and  the  common  people  were  taught  to 
hoot  at  her  as  an  unnatural  mother  who  had  risked  the  lives  of  her  own  chil- 
dren. We  now  read  in  grave  medical  biography,  that  the  discovery  wa9 
instantly  hailed,  and  the  method  adopted  by  the  principal  members  of  that 
profession.  Very  likely  they  left  this  recorded  ;  for  whenever  an  invention 
or  a  project — and"  the  same  may  be  said  of  persons — has  made  its  way  so 
well  by  itself  as  to  establish  a  certain  reputation,  most  people  are  sure  to  find 
out  that  they  always  patronised  it  from  the  beginning,  and  a  happy  gift  of 
forgetfulness  enables  many  to  believe  their  own  assertion.  But  what  said 
Lady  Mary  of  the  actual  fact  and  actual  time  ?  "Why,  that  the  four  great 
physicians  deputed  by  government  to  watch  the  progress  of  her  daughter's 
inoculation,  betrayed  not  only  such  incredulity  as  to  its  success,  but  such  an 
unwillingness  to  have  it  succeed — such  an  evident  spirit  of  rancour  and  ma- 
lignity, that  she  never  cared  to  leave  the  child  alone  with  them  one  second, 
lest  it  should  in  some  secret  way  suffer  from  their  interference." 

Gentlemen,  how  was  the  still  greater  discovery  of  the  immortal  Jenner 
received — Vaccination  ?  Like  every  other  discovery — with  ridicule  and 
contempt.  By  the  Royal  College  of  Physicians,  not  only  was  Jenner  per- 
secuted and  oppressed  ;  but  long  even  after  the  benefits  which  his  practice 
had  conferred  upon  mankind  had  been  universally  admitted,  the  pedants  of 
that  most  pedantic  of  bodies  refused  to  give  him  their  license  to  practise  his 
profession  in  London ;  because,  with  a  proper  feeling  of  self-respect,  he  de- 
clined to  undergo  at  their  hands  an  examination  in  Greek  and  Latin.  The 
qualifications  of  the  schoolmaster,  not  the  attainments  of  the  physician :  the 
locality  of  study,  rather  than  the  extent  of  information  possessed  by  the 
candidate,  were,  till  very  lately,  the  indispensable  preliminaries  to  the 
honours  of  the  College.  Public  opinion  has  since  forced  this  corporation  to  a 
more  liberal  course.  But,  to  return  to  .Tenner :  Even  religion  and  the  Bible 
were  made  engines  of  attack  against  him.  From  these  Errhman  of  Frank- 
fort deduced  his  chief  grounds  of  accusation  against  the  new  practice ;  and 
he  gravely  attempted  to  prove,  from  quotations  of  the  prophetical  parts  of 
Scripture,  and  the  writings  of  the  fathers  of  the  church,  that  Vaccination 
was  the  real  Antichrist !  From  all  this  yon  perceive  that  mankind  have  not 
very  greatly  changed  since  the  time  of  Solomon,  who,  after  searching  the 
world,  "  returned  and  saw  under  the  sun,  that  there  was  neither  bread  to  the 
wise,  nor  riches  to  men  of  understanding,  nor  favour  to  men  of  skill.'" 

Gentlemen,  the  ancients  endeavoured  to  elevate  physic  to  the  dignity  of  a 
science,  but  failed.  The  moderns,  with  more  success,  have,  endeavoured  to 
reduce  it  to  the  level  of  a  trade.  Till  the  emoluments  of  those  who  chiefly 
practise  it  cease  to  depend  upon  the  quantity  of  useless  drugs  they  merci- 
lessly inflict  upon  their  deluded  patients — till  surgeons  shall  be  other  than 
mechanics,  and  physicians  something  more  than  mere  puppets  of  the  apothe- 
cary ;  till  the  terrible  system  of  collusion,  which  at  present  prevails  under 
the  name  of  a  "  good  understanding  among  the  different  branches  of  the  pro- 
fession" be  exposed,  the  medical  art  must  continue  to  be  a  source  of  destruc- 
tion to  the  many — a  butt  for  the  ridicule  of  the  discerning  few.  The  Wits 
of  every  age  and  country  have  amused  themselves  at  the  expense  of  the  phy- 
sician; against  his  science  they  have  directed  all  the  shafts  of  their  satire; 
and  in  the  numerous  inconsistencies  and  contradictions  of  its  professors  they 
have  found  matter  for  some  of  their  richest  scenes.  Moliere,  so  long  the  ter- 
ror of  the  apothecaries  of  Paris,  makes  one  of  his  drawn  say  to 
another — "Call  in  a  doctor,  and  if  you  do  not  like  his  physic,  I'll  Boon  find 
you  another  who  will  condemn  it."  Rousseau  shown!  his  distrust  of  the 
entire  faculty  when  he  said,  "  Science  which  instructs  and  physic  which  cures 
us,  are  excellent,  certainly;  but  Bcience  which  misleads  and  physic  which 
destroys  ns,  arc  equally  execrable  :  teach  us  how  to  distinguish  them."  Quite 
as  sceptical  as  to  its  use,  and  rather  more  sarcastic  in  his  satire  of  the  profes- 


LECTURE  I.  ox 

sion,  was  Le  Sage — "  Death,"  says  he,  "  has  two  wings ;  on  one  are  painteci 
war,  plague,  famine,  fire,  shipwreck,  with  all  the  other  miseries  that  every 
instant  offer  him  a  new  prey.  On  the  other  wing  you  behold  a  crowd  of 
young  physicians  about  to  take  their  degree  before  him.  Death  proceeds  to 
dub  them  doctors,  (leur  donne  de  bonnet,)  having  first  made  them  swear  never 
in  any  way  to  alter  the  established  practice  of  physic." 

The  established  practice  of  physic  !  Who  could  possibly  think  of  altering 
it  ?  Altering  perfection  !  According  to  every  professor  in  every  university 
where  medicine  is  studied,  there  is  no  science  so  glorious — so  Godlike  ! 
Outside  the  walls  of  the  schools,  it  is  true,  you  occasionally  hear  people  speak- 
ing against  it.  Gentlemen,  take  no  heed  of  such  unbelievers !  What  could 
persons  like  Moliere,  or  Rousseau,  or  Le  Sage,  know  of  an  art  they  were 
never  bred  to  ?  That  the  Great  Frederick  all  his  life  laughed  at  medical 
men,  is  nothing  remarkable.  A  man  who,  in  one  day,  had  killed  more  than 
all  the  doctors  in  Europe  could  do  in  a  month,  might  well  be  excused  his 
laugh.  On  that  score,  too,  we  pardon  Napoleon,  who  expressed  a  similar 
contempt  for  medicine.  But  the  Prince  de  Ligne,  though  a  wit  as  well  as  a 
warrior,  is  not  to  be  forgiven  so  easily.  With  all  their  professed  scorn,  Fred- 
erick and  Napoleon,  when  sick,  took  physic.  Not  so  the  Prince  de  Ligne:  when 
attacked  with  fever  he  had  the  presumption  to  thank  Heaven  he  had  no  doc- 
tor near  him ;  and  he  actually  attributed  his  recovery  to  his  good  fortune  in 
that  respect !  If  ever  a  man  deserved  death,  it  was  that  Prince  de  Ligne, 
for  giving  Nature  the  trouble  of  curing  his  fever,  without  once  calling  in  the 
Baillie  or  Halford  of  his  day  to  assist !  The  misfortune  is,  this  unbelieving  spirit 
is  not  confined  to  the  continent.  Locke,  Smollett,  Goldsmith,  (all  three  phy- 
sicians,) held  their  art  in  contempt.  Swift,  Temple,  Hume,  Adam  Smith — 
to  say  nothing  of  Byron,  Hazlitt,  and  other  contemporaries — were  equally 
severe  on  its  professors.  Byron,  indeed,  anathematised  it  as  "  the  destructive 
art  of  healing  ;"  and  when  writing  to  a  friend  the  details  of  a  fever  from  which 
he  had  s^^ffered,  in  something  like  the  vein  of  the  Prince  de  Ligne,  he  tells 
him,  "  I  got  well  by  the  blessings  of  barley-water,  and  refusing  to  see  my 
physician  !"  Gentlemen,  do  you  think  that  all  these  remarkable  persons 
were  inferior  in  observation  and  reflection,  to  the  herd  of  doctors  and  apothe- 
caries who  swarm  in  these  times  ? 

But  so  completely  at  variance  with  each  other  are  even  the  greatest  medi- 
cal authorities  on  every  subject  in  medicine,  that  I  do  not  know  a  single  dis- 
ease in  which  you  will  find  any  two  of  them  agreeing.  Take  the  subject  of 
Pulmonary  Consumption,  for  example  ;  The  celebrated  Stohl  attributed  the 
frequency  of  consumption  to  the  introduction  of  the  Peruvian  bark.  The 
equally  celebrated  Morton  considered  the  bark  an  effectual  cure.  Reid  as- 
cribed its  frequency  to  the  use  of  mercury.  Brillonet  asserted  that  it  is  only 
curable  by  this  mineral.  Rush  says,  that  consumption  is  an  inflamma- 
tory disease,  and  should  be  treated  by  bleeding,  purging,  cooling  medi- 
cines, and  starvation.  With  a  greater  show  of  reason,  Salvadori  maintained 
the  disease  to  be  one  of  debility,  and  that  it  should  be  treated  by  tonics, 
stimulating  remedies,  and  a  generous  diet.  Galen,  among  the  ancients,  re- 
commended vinegar  as  the  best  preventive  of  consumption.  Dessault,  and 
other  modern  writers,  assert  that  consumption  is  often  brought  on  by  a  com- 
mon practice  of  young  people  taking  vinegar  to  prevent  their  getting  fat. 
Dr.  Beddoes  recommended  foxglove  as  a  specific  in  consumption.  Dr.  Parr, 
with  equal  confidence,  declared  that  he  found  foxglove  more  injurious  in  his 
practice  than  beneficial !  Now,  what  are  we  to  infer  from  all  this  ?  Not  as 
some  of  you  might  be  tempted  to  believe,  that  the  science  is  deceptive  or 
incoinprehensive  thoughout,  but  that  its  professors  to  this  very  hour  have 
neglected  to  make  themselves  acquainted  with  the  true  principles  upon  which 
remedies  act,  and  know  as  little  of  the  true  nature  of  the  diseases  whose 
treatment  they  so  confidently  undertake.  And  what  is  the  daily,  the  hourly- 
result  of  this  terrible  ignorance  and  uncertainty  ?     In  the  words  of  Frank, 


22  LECTURE  I. 

•'  Thousands  arc  slaughtered  in  the  quiet  sirk  room."  "  Governments,'" 
continues  the  same  physician,  "  should  at  once  either  banish  medical  men 
and  their  art,  or  they  should  take  proper  means  that  the  lives  of  people  may 
he  safer  than  at  present,  when  they  look  far  less  after  the  practice  of  this 
dangerous  profession,  and  the  murders  committed  in  it,  than  after  the  lowest 
trades. " 

"  If  false  facts,"  says  Lord  Bacon,  "  be  once  on  foot,  what  through  ne- 
glect of  examination,  the  countenance  of  antiquity,  and  the  use  made  of  them 
in  discourse,  they  are  scarce  ever  retracted."  The  late  Professor  Gregory 
scrupled  not  to  declare  in  his  class-room,  that  ninety-nine  out  of  every  hun- 
dred medical  facts  were  so  many  medical  lies,  and  that  medical  doctrines 
were  for  the  most  part  little  better  than  stark-staring  nonsense ; — and  this, 
Gentlemen,  we  shall  have  some  amusement  in  proving  to  you.  In  the  mean 
time,  I  may  observe,  that  nothing  can  more  clearly  explain  the  difficulties 
which  beset  the  student  of  physic — for  who  can  understand  nonsense,  and, 
when  clothed  in  phrases  which  now  admit  one  sense,  now  another,  what  so 
difficult  to  refute?  "  Nothing,"  says  Sir  Humphrey  Davy,  "has  so  much 
checked  the  progress  of  philosophy,  as  the  confidence  of  teachers  in  deliver- 
ing dogmas  as  truths  which  it  would  be  presumptuous  to  question.  It  was 
this  spirit  which  for  more  than  ten  centuries,  made  the  crude  physics  of 
Aristotle  the  natural  philosophy  of  the  whole  of  Europe.  It  was  this  spirit 
which  produced  the  imprisonment  of  the  elder  Bacon  and  the  recantation  of 
Galileo.  It  is  this  spirit,  notwithstanding  the  example  of  the  second  Bacon 
assisted  by  his  reproof,  his  genius,  and  his  influence,  which  has,  even  in  later 
times,  attached  men  to  imaginary  systems, — to  mere  abstracted  combinations 
of  words,  rather  than  to  the  visible  and  living  world ;  and  which  has  often 
induced  them  to  delight  more  in  brilliant  dreams  than  in  beautiful  and  grand 
realities." 

Imposed  upon  by  these  abstracted  combinations  of  words,  we  find  it  diffi- 
cult to  divest  ourselves  of  the  erroneous  and  mystical  distinctions  by  which  our 
teachers  have  too  often  endeavoured  to  conceal  their  own  ignorance: — for  in 
the  "  physical  sciences," — I  again  quote  Sir  Humphrey  Davy, — "  there 
are  much  greater  obstacles  in  overcoming  old  errors,  than  m  discovering  new 
truths — the  mind  in  the  first  case  being  fettered  ;  in  the  last,  perfectly  free 
in  its  progress."  "  To  say  that  any  class  of  opinions  shall  not  be  impugned 
— that  their  truth  shall  not  be  called  in  question,  is  at  once  to  declare  that 
these  opinions  are  infallible  and  that  their  authors  cannot  err.  What  can  be 
more  egregiously  absurd  and  presumptuous?  It  is  firing  bounds  to  human, 
knowledge,  and  saying  men  cannot  learn  by  experience — that  they  can  never 
be  wiser  in  future  "than  they  are  to-day.  The  vanity  and  folly  of  this  is 
sufficiently  evinced  by  the  history  of  religion  and  philosophy.  Great 
changes  have  taken  place  in  both,  and  what  our  ancestors  considered  indis- 
putable truths,  their  posterity  discovered  to  be  gross  errors.  To  continue 
the  work  of  improvement,  no  dogmas,  however  plausible,  ought  to  be  pro- 
tected from  investigation." 

In  the  early  history  of  every  people,  we  find  the  priest  exercising  the 
functions  of  the  physician.  Looking  upon  the  throes  of  disease  as  the  work- 
ings of  devils,  his  resource  was  prayer  and  exorcism  ;  the  maniac  and  epilep- 
tic were  termed  by  him  demoniacs,  and  when  a  cure  was  accomplished,  the 
demon  was  said  to  be  cast  out.  Even  now,  the  traces  of  clerical  influence 
on  our  art  are  not  extinct  in  England ;  for  though  our  churchmen  have  long 
ceased  to  arrogate  to  themselves  the  exclusive  right,  as  well  as  the  exclusive 
power  of  healing,  an  Archbishop  of  Canterbury  is  still  permitted,  by  tho 
laws  of  his  country,  to  confer  degrees  in  physic  !  nor  does  he  fail  even  in 
these  days  to  avail  himself  occasionally  of  mi  prerogative. 

"We  are  told  by  the  ingenious  John  Brown  that  he  "  wasted  more  than 
twenty  years  in  learning,  teaching,  and  diligently  scrutinising  every  part  of 
medicine.     The  first  five  passed  away  in  hearing  others,  studying"  what  he 


LECTURE  I.  23 

had  heard,  implicitly  believing  it,  and  entering  upon  the  possession  a9  a  rich 
and  valuable  inheritance.  His  mode  of  employment  the  next  five  years  was 
to  explain  more  clearly  the  several  particulars,  to  refine  and  give  them  a 
nicer  polish.  During  the  next  equal  space  of  time,  because  no  part  of  it  had 
succeeded  to  his  mind,  he  became  cold  upon  the  subject,  and  with  many 
eminent  men,  even  with  the  vulgar  themselves,  began  to  deplore  the  healing 
art  as  altogether  uncertain  and  incomprehensible.  All  this  time  passed  away 
without  the  acquisition  of  any  advantage,  and  of  that  which  of  all  things  is 
most  agreeable  to  the  mind — the  light  of  truth ;  and  so  great,  so  precious  a 
portion  of  the  fading  and  short-lived  age  of  man  was  lost.  It  was  only  be- 
twixt the  fifteenth  and  twentieth  year  of  his  studies  that,  like  a  traveller  in 
an  unknown  country,  wandering  in  the  shade  of  night,  after  losing  every 
trace  of  his  road,  a  very  obscure  gleam  of  light,  like  that  of  the  first  break 
of  day,  dawned  upon  him." 

Gentlemen,  it  was  my  fortune  to  be  more  early  staggered  with  the  inadequa- 
cy of  received  doctrines  either  to  explain  Disease  or  cure  it.  I  therefore  de- 
termined to  read  anew  the  Book  of  Nature,  and  study  it  by  the  light  of  such 
common  sense  as  God  in  his  goodness  had  given  me,  rather  than  trust  any 
longer  to  the  reports  of  fallacious  commentators.  To  this  investigation  I 
came  with  a  different  spirit  from  that  with  which  I  entered  the  schools  of 
physics.  In  my  noviciate  I  yielded  implicit  faith  to  my  teachers  ;  in  my 
later  researches  after  truth,  I  have  often  had  to  guard  myself  as  much  against 
a  too  rigorous  scepticism  of  their  facts  as  a  too  great  contempt  of  their 
opinions.  With  Lord  Bolingbroke,  I  can  truly  say,  "  few  men  have  con- 
sulted others,  both  the  living  and  the  dead,  with  less  presumption,  and  in  a 
greater  spirit  of  docility  than  I  have  done  ;  and  the  more  I  have  consulted 
the  less  I  have  found  of  that  inward  conviction  on  which  a  mind  that  is  not 
absolutely  implicit  can  rest.  I  thought  for  a  time  that  this  must  be  my  fault ; 
I  distrusted  myself,  not  my  teachers — men  of  the  greatest  name,  ancient  and 
modern  ;  but  I  found  at  last  it  was  safer  to  trust  myself  than  them,  and  to 
proceed  by  the  light  of  my  own  understanding,  than  to  wander  after  these 
ignus  fatui  of  philosophy." 

After  a  long  and  diligent  scrutiny  of  Nature  in  this  spirit,  I  have  at  last 
been  enabled  to  place  before  the  profession  a  Doctrine  of  Disease,  and  a  Me- 
thod of  Cure,  which,  when  the  unity  of  principle  of  the  one  and  the  univer- 
sality of  application  of  the  other  have  been  fairly  tested,  will  tend,  I  hope,  to 
rescue  physic  and  physicians  from  the  obloquy  and  contempt  with  which  the 
more  thinking  part  of  the  public  have  too  long  looked  upon  both. 

In  the  course  of  these  Lectures,  gentlemen,  it  shall  be  my  business  to 
prove  to  you  the  unity  or  indentity  of  all  morbid  action,  and  the  unity 
and  identity  of  the  source  of  power  of  the  various  agencies  by  which  disease 
of  every  kind  may  be  caused  or  cured.  "  The  universe,"  says  D'Alembert, 
"  to  him  who  should  have  sufficient  comprehension  to  behold  it  at  a  single 
view,  would  only  appear  one  great  fact — one  mighty  truth."  And  in  the 
same  spirit  Sir  James  M'Intosh  observes,  "  the  comprehensive  understanding 
discovers  the  identity  of  facts  which  seem  dissimilar,  and  binds  together 
into  a  system  the  most  apparently  unconnected  and  unlike  results  of  experi- 
ence." Beware,  then,  of  differences — of  .division  ;  for  as  Lord  Bacon  well 
observes,  "  divisions  only  give  us  the  husks  and  outer  parts  of  a  science, 
while  they  allow  the  juice  and  kernel  to  escape  in  the  splitting."  And  from 
this  you  may  learn  not  only  the  absurdity  of  nosological  distinctions,  but  also 
the  utter  nothingness  and  vanity  of  the  many  disputes  that  daily  occur  in 
practice,  whether  disorders  resembling  each  other,  and  amenable  to  the 
6ame  treatment,  should  be  called  by  one  name  or  another.  In  the  language 
of  Hobbes,  "  words  are  wise  men's  counters, — they  do  but  reckon  by  them  ; 
but  they  are  the  money  of  fools,  that  value  them  by  the  authority  of  an 
Aristotle,  a  Cicero,  a  Thomas  Aquinas,  or  any  other  doctor  whatsoever." 
More  than  twentv-three  centuries  have  elapsed  since  Hippocrates  dia- 


24  LECTURE  I. 

tinctly  announced  the  Unity  of  Morbid  Action, — Omnium  inorborum  unus  et 
idem  modus  tat."  The  Type  of  all  disease  is  o>e  and  identical. 
These  are  his  words,  and  that  is  my  case.  That  is  the  cause  I  am  prepared 
to  enter  upon  with  as  perfect  a  chain  of  positive  and  circumstantial  proof  in 
its  support  as  ever  was  offered  to  human  investigation.  Gentlemen,  what 
Johnson  said  of  poets  is  equally  applicable  to  physicians  :  "  The  first,  who- 
ever they  be,  must  take  their  sentiments  and  descriptions  immediately  from 
knowledge — their  descriptions  are  verified  by  every  eye,  and  their  senti- 
ments acknowledged  by  every  ,  breast.  Those  whom  their  fame  invites 
to  the  same  studies  copy  partly  them  and  partly  nature,  till  the  books  of  one 
age  gain  such  authority  as  to  stand  in  the  place  of  nature  to  another."  It  is 
in  this  manner  that  the  descriptions  of  disease  in  our  nosological  systems  have 
become  a  mere  tissue  of  unnatural  division,  not  to  say  of  the  most  obvious 
contradiction ;  if  the  words  in  which  they  be  conveyed  have,  in  many  in- 
stances, any  meaning  at  all.  What,  then,  shall  we  say  of  reasoning  founded 
upon  facts  which  are  no  facts — upon  mere  assumptions  which  have  no  foun- 
dation in  nature  ! 

The  schools  of  Egypt  and  Arabia,  the  eminent  men  of  Greece  and  Rome, 
the  great  anatomical  teachers  and  philosophers  of  the  middle  ages,  knew  not 
the  circulation  of  the  blood.  How  wild  were  their  theories,  how  fanciful 
their  hypotheses,  may  be  gleaned  from  the  fact  of  their  naming  certain  blood- 
vessels, arteries,  or  air-vessels  ;  tubes,  which  you  have  only  to  wound  to  see 
them  pour  out  the  living  current  in  jets,  were  for  ages  supposed  to  contain 
not  blood,  but  air !  What  innumerable  fallacies  must  have  entered  into 
J  reasoning  founded  on  such  premises  !  Yet  it  was  not  till  the  seventeenth 
century  that  the  illustrious  Harvey  demonstrated  the  true  nature  of  the  ar- 
teries, and  the  manner  in  which  the  blood  circulates  through  the  body.  The 
more  immediate  reward  of  his  discovery  was  calumny,  misrepresentation, 
and  loss  of  his  professional  practice.  The  same  College  of  Physicians  who, 
in  after  years,  opposed  the  improvements  of  Montague  and  Jenner,  made  the 
Circulation  of  the  Blood  the  subject  of  their  bitterest  satire.  Not  content 
with  slandering  the  character  of  its  discoverer,  the  more  vile  and  venal  of  his 
medical  brethren  made  it  a  pretext  for  declining  to  meet  him  in  consultation. 
Harvey  lived,  nevertheless,  to  neutralise  the  malice  of  his  enemies ;  be  be- 
came successively  the  physician  of  the  first  two  English  kings  of  the  Stuart 
race,  James  and  Charles. 

The  more  you  can  explain  and  facilitate  the  attainment  of  any  science,  the 
more  you  will  find  that  science  approach  perfection.  The  true  philosopher 
has  always  studied  to  find  out  relations  and  resemblances  in  nature,  thus  sim- 
plifying the  apparently  wonderful ; — the  schools,  on  the  contrary,  have  as 
invariably  endeavoured  to  draw  fine-spun  distinctions  and  differences,  the 
more  effectually  to  perplex  and  make  the  most  simple  things  difficult  of  ac- 
cess. "  In  universities  and  colleges,"  says  Lord  Bacon,  "  men's  studies  are 
almost  confined  to  certain  authors,  from  which  if  anv  dissenteth  or  propoun- 
ded! matter  of  redargution,  it  is  enough  to  make  him  be  thought  a  person 
turbulent.  Any  exposition  of  the  singleness  of  principle  wliieh  pervade*  a 
particular  science,  will  be  sure  to  meet  the  censure  of  schools  and  col 
nor  will  their  disciples  always  forgive  you  for  making  that  easy  which  they 
themselves,  after  years  of  study,  have  declared  to  be  incomprehensible. 

The  most  perfecl  system  lias  ever  been  allowed  n.  be  that  which  van  re- 
concile and  bring  together  the  greatest  number  of  facta  that  come  within  the 
sphere  of  the  subject  of  it.     In  this  coj  idory  of  Newton,  whoet 

discovery  rests  upon  no  higher  order  of  proof.     How  was  this  disCo< 
eeived  upon  its  firs!  announcement  ?     In  the  words  of  Dr.  Chalmers,  »  autho- 
rity scowled  upon  it  ;  and  taste  was  disgusted  by  it  ;  and  fashion  was  ai 
ot   it.;   and  all  the  beauteous  speculation  of  former  days  was   cruelly    broken 
up  by  this  new  announcement   of  the    better    philosophy,  and   scatt'i  red    like 
the  fragments  of  an   aerial    vision  over    which    the    past   generations  of  the 


LECTURE  I.  25 

world  had  been  slumbering  their  profound  and  pleasing  reveries."  For  up- 
wards of  ten  centuries  had  the  false  prophesy  of  Aristotle  enslaved  the 
minds  of  civilised  Europe,  thus  at  last  to  perish  and  pass  away  !  So  that 
Time  itself  is  no  sure  test  of  a  doctrine,  nor  ages  of  ignorance  any  standard 
by  which  to  measure  a  system.  To  Nature,  eternal  Nature,  must  Truth 
ever  make  her  first  and  last  appeal.  By  this,  and  this  only,  am  I  willing 
that  the  new  fabric  of  medicine  which  I  have  presumed  to  erect  upon  the 
ruins  and  reveries  of  the  past,  should  be  tested  and  tried.  Till  the  world 
shall  detect  one  real — one  indubitable  fact  militating  against  the  Views  I  am 
now  about  to  develope,  let  not  innovation  be  charged  against  me  as  a  crime 
Hippocrates,  Galen,  Boerhaave,  Cullen,  were  all  innovators  in  their  day,  nay, 
revolutionists  in  physic.  The  revolution  I  meditate,  unlike  those  of  some  of 
my  predecessors,  is  at  least  free  from  the  imputation  of  being  either  painful 
or  sanguinary  in  its  character.  The  only  agents  it  rejects  are  the  leech,  the 
bleeding  lancet,  and  the  cupping  instrument.  Let  us  now  enter  upon  the 
developement  of  this  new,  but  natural  system. 

Gentlemen,  in  the  higher  powers  of  Observation,  Comparison,  Compre- 
hension, and  Direction,  termed  Mind  or  Intellect,  Man  stands  pre-eminent 
above  all  animals  ;  in  so  far  as  regards  the  more  immediate  observation  of 
certain  things  around  him,  he  is  nevertheless  excelled  in  some  respects  by 
many.  The  eagle  has  a  finer  and  farther  sight ;  the  hearing  of  the  mole  is 
more  acute  ;  the  dog  and  the  vulture  distinguish  odours  wholly  inappreciable 
by  him  ;  not  a  few  of  the  wilder  denizens  of  the  forest  have  even  a  keener 
sense  of  taste  and  touch.  In  mere  perceptive  power,  then,  the  beasts  of  the 
field  are  in  some  things  permitted  to  surpass  us  ;  while  the  sagacity  of  the 
elephant  and  the  dog,  the  courage  and  emulation  of  the  horse,  the  foresight 
of  the  ant,  the  cunning  of  the  fox,  and  the  social  and  building  habits  of  the 
beaver,  declare  to  us — however  unpleasing  the  announcement — that  others 
of  God's  creatures  besides  ourselves,  possess  the  elements,  at  least,  of  that 
Reason,  upon  which  we  so  highly  pride  ourselves.  To  the  greater  degree 
of  complexity, — perhaps  I  should  rather  say  completeness,  of  his  cerebral 
organization, — to  his  more  perfect  developement  of  that  source  of  all  reason- 
ing power,  the  Brain, — man  assuredly  owes  this  corresponding  increase  in 
the  number  and  force  of  his  reasoning  faculties.  The  more  complete  me- 
chanism of  his  prehensible  organ,  the  Hand,  gives  him  the  power  to  execute 
what  his  Head  conceives,  in  a  degree  of  perfectibility  that  we  look  for  in 
vain  in  the  works  of  any  other  tribe  of  the  animal  kingdom.  Look  at 
"  man's  full  fair  front ;"  it  is  a  superadded — not  a  superfluous  part ;  the  more 
it  diminishes  and  recedes,  the  nearer  you  will  find  its  possessor  to  be  akin  to 
the  brute. 

But,  gentlemen,  the  rudiments  of  every  portion  of  this  instrument  of  man's 
reasoning  faculties, — this  directing  Brain, — variously  developed,  may  be  de- 
tected in  almost  every  link  of  the  great  chain  of  animated  beings  of  which  he 
is  confessedly  the  chief.  To  every  variety  of  race  that  animates  the  globe, 
whether  in  external  or  internal  configuration,  we  have  undeniably  many  fea- 
tures of  relationship  ;  nor  let  us  spurn  even  the  meanest  and  most  shapeless 
as  beneath  our  notice — for  of  every  organic  production  of  their  common 
Maker,  Man,  while  yet  in  the  womb  of  his  parent,  has  been  the  type  ! — his 
foetal  form  successively  partaking  of  the  nature  of  the  worm,  fish,  and  reptile, 
and  rapidly  traversing  still  higher  gradations  in  the  scale  of  organised  exist- 
ence, to  burst  at  last  upon  the  view  in  all  the  fulness  and  fairness  of  the  per- 
fect infant.  But  it  is  not  in  his  outward  form,  only,  that  he  passes  through 
these  various  gradations  of  animal  life.  From  Comparative  Anatomy  we 
also  learn  that  each  of  his  separate  internal  organs,  on  first  coming  into  foetal 
existence,  assumes  the  lowest  type  of  the  same  organ  in  the  animal  kingdom ; 
and  it  is  only  by  successive  periodic  transformations  that  it  gradually  ap- 
proaches to  the  degree  of  completeness  in  which  we  find  it  in  the  new-born 
child.     The  heart  of  the  embryo-infant  is  a  mere  canal,  nearly  straight  at 


26  LECTURE  I. 

first,  and  then  slightly  curved,  corresponding  exactly  with  the  simplicity  of 
heart  of  insect  life — that  of  the  snail,  and  other  insects  of  the  lowest  Crustacea 
tribe,  for  example.  And  not  the  heart  alone,  but  each  and  all  of  the  several 
organs  and  systems  of  the  body  are  brought  to  their  perfection  by  periodic 
additions  and  superadditions  of  the  simpler  and  more  complex  parts  of  the 
same  oreans  and  systems  of  the  several  orders  of  animals,  from  the  least  noble 
to  the  highest  class  of  all — the  Mammalia,  of  which  Man  is  the  head.  Man, 
proud  man,  then  commences  his  foetal  life  in  reality  a  worm! — and  even  when 
he  has  come  into  the  world,  and  has  breathed  and  cried,  it  is  long  before  the 
child  possesses  the  mental  intelligence  of  many  of  the  adult  brutes ;  in  this 
respect  Man  is  for  a  period  lower  than  the  monkey — the  monkey  he  so  hates 
and  despises  for  its  caricature  likeness  of  himself.  Between  the  same  Man 
in  his  maturity,  and  his  animal  fellow-creatures,  we  perceive  many  differences ; 
the  resemblances,  being  infinitely  more  numerous,  as  a  matter  of  course  escape 
our  memory !  Are  not  the  higher  order  of  animals,  and  most  of  the  very 
lowest,  propagated  by  sexes  ?  Does  not  the  female  endure  her  period  of  tra- 
vail like  woman,  and  produce  and  suckle  her  young  in  a  similar  manner  ? 
Have  not  animals  senses  to  see,  hear,  smell,  taste,  and  touch,  and  has  not  each 
its  respective  language  of  sounds  and  signs  by  which  it  conveys  its  meaning  to 
the  other  individuals  of  its  race  ?  Nay,  have  not  Animals  many  of  Man's 
passions  and  emotions — most  of  his  sympathies  and  antipathies — his  power 
of  choice  and  resistance — the  knowledge  by  Comparison  who  is  their  friend, 
and  who  their  foe — Reflection,  whom  to  conciliate,  whom  to  attack  ;  where  to 
hide,  and  when  to  show  themselves — the  Memory  of  injury  and  kindness — 
Imitation,  and  consequent  docility — in  some  instances,  Simulation  and  Dis- 
simulation each  pursuing  its  own  mode  of  artifice  ?  Do  not  their  young,  too, 
as  in  the  instance  of  the  child,  gambol  and  play,  and  like  it  leave  off  both  as 
they  grow  older,  for  other  pleasures  ?  And  yet  there  are  persons  of  a  temper 
so  unphilosophical  as  to  deny  them  Mind  !  Does  man  possess  a  mental  supe- 
riority of  the  dog  greater,  or  as  great,  as  the  dog  has  over  the  oyster  ?  Of 
mental  as  of  physical  power,  there  are  gradations.  If  we  have  stupid  and 
clever  men,  so  have  we  stupid  and  clever  animals,  according  to  their  respective 
races.  But  there  are  dogs  that  will  observe,  calculate,  and  act  more  ration- 
ally than  some  human  fools  you  may  see  every  day.  When  did  you  find  the 
dog  prostrating  himself  before  a  figure  of  his  own  making,  asking  it  questions, 
supplicating  it,  and  howling,  and  tearing  his  hair,  because  it  answered  him 
not  ?  Which  of  all  the  Brutes  (parrels  with  his  fellow-brute  for  going  his 
own  road,  whether  circuitous  or  otherwise,  to  a  town  or  village,  that  does 
not  concern  the  other  in  the  least?  Or  which  of  all  the  animal  tribes  mani- 
fests such  a  paucity  of  intellect  as,  more  than  once,  to  mistake  the  same  false 
signs  for  real  sense,  imposture  for  integrity,  gravity  for  wisdom,  antiquity  foi 
desert  ?  Never  in  my  life,  gentlemen,  did  I  see  the  dog  or  monkey  implicitly 
submitting  himself  to  another  of  his  race  in  matters  that  especially  interested 
himself.  The  monkey,  for  example,  instead  of  trusting  to  the  authority  of 
his  fellow-monkey,  hi  a  spirit  of  laudable  curiosity,  always  handles  with  his 
tiny  fingers,  and  examines  with  his  quick  prying  eyes,  every  thing  that  takes 
his  fancy;  in  no  single  instance  that  I  remember  did  I  ever  Bee  him  allow 
himself  to  be  taken  by  the  ears.  Even  in  his  language  of  chatter  and  gibb<  r. 
he  never  seems  to  mistake  the  meaning  of  his  comrades,  never  takes  one 
sign  in  two  or  more  senses, — senses  the  most  opposite, — so  as  to  gel  coaraeed 
and  bewildered  in  his  manner  or  his  actions.  Can  you  always  say  this  trf 
man?  Have  you  never  heard  him,  even  in  his  discussions  on  this  very  sub- 
ject, one  moment  charging  everything  of  animal  Intelled  to  Mind,  at  another 
to  Instinct, — instinct  which,  to  have  a  meaning  at  all,  must  mean  tins — ri^ht. 
action  without  experience, — such  as  the  infant  taking  its  mother's  bri 
soon  as  born,  or  the  chick  picking  up  grain  the  moment  it  leaves  the  shell. 
True,  the  chick  may  mistake  a  particle  of  chalk  for  a  grain  of  v.  | 
the  infant  may  mistake  his  nurse's  finger  for  the  nipple  of  his  mother.     Expo- 


LECTURE  I.  27 

rience  corrects  the  error  of  both ;  and  this  correction  of  error  is  one  of  the 
first  efforts  of  the  three  mental  faculties,  Observation,  Comparison,  and  Re- 
flection. It  is  with  these  identical  faculties  that  both  men  and  animals  per- 
ceive a  relationship  betwixt  two  or  more  things,  and  act  in  regard  to  such 
things  according  to  their  respective  interests, — rightly  in  some  instances, 
wrongly  in  others.  The  correction  to-day  of  the  errors  of  yesterday  is  the 
chief  business  of  Man.  As  he  grows  in  years,  his  experience  of  things  en- 
larges, and  his  judgment  as  to  their  true  value  and  relationship  to  himself 
becomes  more  and  more  matured.  The  Brutes,  then,  have  the  very  same 
intellectual  faculties  variously  developed,  which,  when  stimulated  to  their 
utmost  in  Man,  and  with  the  assistance  of  his  higher  moral  faculties,  become 
Genius, — if  by  genius  is  meant  the  discovery  of  relationships  in  nature 
hitherto  undiscovered,  and  leading,  as  all  such  discoveries  do,  to  practical  re- 
sults beyond  cotemporary  anticipation — Newton's  system  and  Watt's  steam- 
engine  for  example. 

Gentlemen,  .you  now  clearly  see  that  in  the  power  of  gaining  knowledge  by 
experience, — call  it  Mind,  Reason,  Intellect,  or  what  you  please, — the  Beast 
of  the  field  partakes  in  common  with  man,  though  not  in  the  same  degree  ; 
yet  both  partake  of  it  in  a  degree  equal  to  the  particular  condition  and  exi- 
gencies in  which  they  are  individually  or  socially  placed.  For  animals,  like 
men,  have  their  cities  and  sentinels — their  watchwords  of  battle,  siege  and 
defence  :  nature,  too,  has  given  them  all  their  respective  weapons  of  offence 
and  defence.  Man,  less  gifted  in  either  of  these  respects,  first  fashioned  his 
sword,  and  his  shield,  and  his  armour  of  proof.  It  was  only  after  the  expe- 
rience of  centuries,  he  reached,  by  higher  mental  efforts,  to  the  knowledge 
necessary  for  the  construction  of  the  musket,  the  cannon,  and  the  other  mu- 
nitions of  modern  warfare.  Necessity  was  the  mother  of  his  invention  here, 
as,  indeed,  in  every  other  instance  ;  but  by  this  also  the  lower  animals  profit. 
What  but  necessity  enables  our  domestic  animals  to  change  their  habits  so  as 
to  live  in  peace,  harmony,  or  slaverv  with  man? — even  as  necessity  obliges 
man  enslaved  to  do  and  bear  for  his  fellow-man  things  the  most  repugnant  to 
his  nature.  How  different  the  habits  of  the  domestic  dog  from  the  dog  or 
wolf  of  the  prairie,  from  which  he  originally  sprang !  In  the  wilderness,  the 
one  would  all  but  perish  for  want,  till  stern  necessity  should  teach  him  to 
hunt  down  his  prey  ;  the  other  would  require  stripes  and  blows  through  suc- 
cessive generations,  before  he  could  be  taught,  like  the  shepherd's  dog,  to 
come  at  his  name,  and  to  drive  the  sheep  at  his  master's  call,  or  arithmetically 
to  single  out  from  the  herd  two,  three,  or  more,  and  watch  or  urge  them  on  at 
his  bidding.  To  deny  animals  mind  is  to  deny  them  design,  without  which, 
putting  mere  instinct  apart,  neither  men  nor  animals  act  in  any  manner  or 
matter.  The  great  Designer  of  the  Universe,  in  the  creation  of  the  first 
crystal,  showed  this.  He  proclaimed  it  when  he  made  the  sexes  of  the  vege- 
table kingdom ; — when,  by  the  Zeophyte  or  plant-animal,  he  united  the  vege- 
table to  the  lowest  link  of  the  animal  world,  he  made  his  design  still  more 
manifest.  When  he  further  progressively  developed  his  plan  of  insect,  fish, 
and  reptile  life,  and  added  the  higher  animals  last  of  all,  before  he  completed 
the  chain  with  Man  their  master,  he  showed  not  only  design,  but  Unity  of 
Design  ;  and  when  to  men  and  animals  he  gave  a  power  neither  the  crystal 
nor  the  vegetable  possesses, — the  power  of  following  out  designs  of  their  own 
making, — he  imbued  them  both  with  a  portion  of  His  Spirit ;  varying  in  de- 
gree, but  to  each  he  gave  it  in  a  measure  equal  to  their  respective  wants  and 
necessities.  Deny  this,  and  you  deny  God, — you  deny  God's  works  and 
words ;  words  upon  which  the  question  of  interpolation  can  never  arise  :  for 
every  leaf  of  every  plant  is  a  letter  of  His  alphabet ;  every  tree  a  combina- 
tion of  the  letters  composing  it,  and  every  hill,  valley  and  stream— every 
tribe  of  men  and  animals,  so  many  sentences  by  which  we  may  perceive  His 
will,  and  deduce  His  law.  The  stars,  and  constellations  of  stars,  and  their 
periodic  motions,  teach,  even  to  our  frail  senses,  the  analogies  which  subsist 


28  LECTURE  I. 

in  this  respect  between  the  motions  of  man's  body  and  all  the  movements  of 
Nature.  In  their  harmony  of  design,  they  give  U9  an  insight  into  the  Unity 
of  the  Etkrnai.  And  we  find  embodied"  in  them  a  principle  by  which  we 
not  only  may  know  the  past  and  present,  but  to  a  certain  extent  read  the 
future,  in  its  dim  outline  of  twilight  and  shadow.  In  all  humility,  then,  let 
us  inwardly  prostrate  ourselves  before  the  Omnipotent :  but  let  us  at  the 
same  time  beware  of  that  outward  mock  humility  which  too  often  leads  to 
religious  pride,  and  engenders  anything  but  Christian  charity ;  and  let  it 
rather  be  our  delight  to  trace  resemblances  and  harmonies,  than  to  see  in  Na- 
ture only  discords  and  differences.  The  world — the  universe,  is  a  Unity  ; 
and  in  no  single  instance  do  we  find  a  perfect  independence  in  any  one  thing 
pertaining  to  it.  Betwixt  man  and  the  lower  animals,  we  have  traced  link  by 
link  the  chain  of  contiguity — mental  as  well  as  corporeal.  Like  them,  he 
comes  into  the  world,  and  like  them,  his  body  periodically  grows,  decays,  and 
dies.  When  injured  in  any  of  its  parts,  it  has  similar  powers  of  repair  and 
reproduction.  I  know  not  why  such  powers  should  be  greater  the  further 
we  descend  the  scale ;  but  in  the  crab  and  lobster,  whole  limbs  may  be  sev- 
ered and  reproduced  ;  in  the  worm,  the  regeneration  of  half  the  body  may 
take  place  ;  while  in  man,  the  highest  of  the  chain,  only  limited  portions  of  a 
tissue  can  be  materially  injured  and  recover.  Disease,  like  death,  is  the  des- 
tiny of"  all.  To  understand  either  aright,  we  must  first  know  what  Health  is. 
In  the  state  of 

Health, 

an  equable  and  medium  temperature  prevails  throughout  the  frame.  The 
voluntary  and  other  muscles  obey  with  the  requisite  alacrity  the  several  ne- 
cessities that  periodically  call  them  into  action.  The  mind  neither  sinks  nor 
rises  but  upon  great  emergencies ;  the  respiration,  easy  and  continuous,  re- 
quires no  hurried  eflbrt — no~lengthened  sigh.  The  heart  is  equal  in  its  beats, 
and  not  easily  disturbed  ;  the  appetite  moderate  and  uniform.  At  their  ap- 
pointed periods,  the  various  secreting  organs  perform  their  office.  The 
structures  of  the  body,  so  far  as  bulk  is  concerned,  remain,  to  appearance, 
though  not  in  reality,  unchanged ;  their  possessor  being  neither  encumbered  with 
obesity,  nor  wasted  to  a  shadow.  His  sensorium  is  neither  painfully  acute 
nor  morbidly  apathetic ;  ho  preserves  in  this  instance,  as  in  every  other,  a 
happy  moderation.     His  sleep  is  tranquil,  dreamless. 

If  we  analyze  these  various  phenomena,  we  shall  find  that  they  all  consist 
of  a  series  of  periodic  repetitions,  each  separate  organ  having  its  own  partic- 
ular period  for  the  proper  performance  of  its  function  ;  some  of  these  pheno- 
mena are  diurnal,  some  recur  in  a  greater  or  less  number  of  hours, — while 
others  exhibit  a  minutary  or  momentary  succession.  At  morn,  man  rises  to 
his  labour;  at  night,  he  returns  to  the  repose  of  sleep;  again  he  wakes  and 
labours;  at  the  appointed  period  he  "steeps  his  senses  in  forgetfulness"  unce 
more.  His  lungs  now  inspire  air,  now  expel  it ;  his  heart  successively  contracts 
and  dilates  :  his  blood  brightens  into  crimson  in  the  arterial  circle  of  it*  »••- 
eels — again  to  darken  and  assume  the  hue  of  modena  in  the  veins.  The  female 
partner  of  his  lot — she  who  shares  with  him  the  succession  of  petty  joys  and 
"Sorrows,  hopes  and  fears,  which  make  up  the  day-dream  of  life,  baa  yet 
another  revolution,  the  Cutamenial;  and  Parturition,  or  the  process  by  which 
she  brings  their  mutual  offspring  into  the  world,  is  a  series  of  jicriodic  pains 
and  remissions. 

Every  atom  of  the  material  body  is  constantly  undergoing  a  revolution  or 
alternation  ;  liquid  or  aeriform  one  hour,  it  becomes  solid  the  next  —  again  to 
pass  into  the  liquid  or  aeriform  state  :  and  ever  ami  anon  varying  its  proper- 
ties, colours,  and  combinations,  as,  in  brief,  but  regular  PKRIOBtC  loccession 
it  assumes  the  nature  of  every  organ,  tissue,  and  secretion,  entering  into,  or 
proceeding  from,  the  corporeal  frame.  "It  is  every  tiling  by  tarns,  and 
nothing  long." 


LECTURE  1.  29 

• 

The  phenomena  of  the  human  body,  like  every  other  phenomenon  in  na- 
ture, have  all  a  relation  to  Matter,  Space,  and  Time;  and  there  is  another 
word,  Motion,  which  may  be  said  to  bring  all  three  to  a  unity  ;  for  without 
matter  and  space,  there  can  be  no  motion,  and  motion  being  either  quick  or 
slow,  must  also  express  time  or  period. 

Morever,  there  can  be  no  motion  in  matter  without  change  of  temperature, 
and  no  change  of  temperature  without  motion  in  matter.  This  is  so  indispu- 
table an  axiom  in  physics,  that  Bacon  and  others  supposed  motion  and  change 
of  temperature  to  be  one  and  the  same.  You  cannot,  for  example,  rotate  a 
wheel  for  a  few  seconds,  without  heat  being  produced,  and  the  iron  that  binds 
it  becomes  expanded  ;  in  other  words,  it  exhibits  a  motion  outwards :  when 
the  same  wheel  is  allowed  to  stand  still,  the  temperature  falls,  and  the  iron 
hoop  decreases  in  size.  There  is  in  that  case  motion  inwards.  By  the  same 
law,  if,  even  in  the  middle  of  winter,  you  run  for  any  length  of  time,  you  will 
become  heated  and  bloated ;  and  you  again  shrink  in  size  when  you  stand 
still  to  cool  yourself.  To  the  mind's  eye,  extremis probatis  media  presumuntur. 
Having  shown  the  truth  in  extremes,  we  presume  the  rest ;  for  as  there  are 
motions  both  of  quickness  and  slowness  that  elude  the  eye,  so  are  there 
changes  of  temperature  that  the  thermometer  may  not  reach.  Those,  then, 
who  ascribe  the  source  of  animal  heat  exclusively  to  the  lungs,  seem  to  have 
forgotten  these  facts  :  they  have  forgotten  that,  in  the  constant  mutation  of  its 
atoms,  every  organ,  nay,  every  atom  of  that  organ  being  ever  in  motion, 
must  equally  contribute  to  this  end ;  for  to  this  common  law  of  all  matter, 
every  change  in  the  body  is  subjected.  The  powers  by  which  the  corporeal 
motions  are  influenced,  are  the  same  that  influence  the  motions  of  every  kind 
of  matter,  namely,  the  electric,  mechanical,  and  chemical  forces,  and  the 
force  of  gravitation.  When  rightly  considered,  the  whole  of  these  powers 
resolve  themselves  into  attraction  and  repulsion.  It  is  by  attraction 
that  the  fluid  matter  of  the  blood  first  assumes  the  solid  consistence  of  an 
organ ;  again  to  pass  by  repulsion  into  the  fluidity  of  secretion.  From  the 
earth  and  to  the  earth,  the  matter  composing  our  bodies  comes  and  goes  many 
times  even  in  the  brief  space  of  our  mortal  existence.  In  this,  the  human 
system  resembles  a  great  city,  the  inhabitants  of  which,  in  the  course  of 
years,  are  constantly  changing,  while  the  same  city,  like  the  body,  betrays  no 
other  outward  appearance  of  change  than  what  naturally  belongs  to  the  pe- 
riods of  its  rise,  progress,  maturity,  or  tendency  to  decay. 

The  last,  and  one  of  the  most  important  of  the  revolutions  of  the  healthy 
state,  is 

Sleep. 

Philosophers  of  all  ages  have  made  this  an  object  of  their  most  anxious 
study,  its  relation  to  death,  perhaps,  being  their  chief  inducement  to  do  so. 
"  Half  our  days,"  says  Sir  Thomas  Browne,  "  we  pass  in  the  shadow  of  the 
earth,  and  Sleep,  the  brother  of  Death,  extracteth  a  third  part  of  our  lives." 
In  the  state  of  perfect  sleep,  the  pupil  of  the  eye  will  not  contract  on  the  ap- 
proach of  light ;  the  skin  has  no  feeling ;  the  ear  no  sense  of  hearing :  the 
taste  and  smell  are  not  to  be  roused  by  any  of  the  ordinary  stimuli.  What  is 
this  (figuratively  speaking)  but  a  periodic  half-death :  speaking  truly,  but  a 
periodic  palsy  or  cessation  of  internal  motion  of  the  nerves  by  which  we  main- 
tain a  consciousness  of  existence,  and  perceive  our  relationship  to  the  world 
around  us  1  Broken  sleep  consists  either  in  brief  remissions  of  the  whole 
sleeping  state,  or  in  a  wakefulness  of  one  or  more  of  the  five  senses.  There 
are  individuals,  for  example,  who  always  sleep  with  their  eyes  open,  and  who 
would  see  you,  were  you  to  enter  their  chamber  with  the  most  noiseless 
tread.  These  tell  you  they  are  always  half  awake.  In  the  condition  of  body 
teemed  nightmare,  there  is  a  consciousness  of  existence  with  a  wakefulness 
of  the  nerves  of  sight  or  feeling;  but  with  a  total  inability  to  influence  the 
voluntary  muscles  by  any  efforts  of  the  will.     The  subject  of  it  can  neither 


30  LECTURE  I. 

sleep  nor  turn  himself.  The  dreamer,  portions  of  whose  brain  think,  and 
therefore  act  or  move,  is  partially  awake.  The  somnambulist  and  sleep-talker 
are  dreamers,  who,  having  portions  of  the  brain  in  a  state  of  action,  and 
others  torpid,  perform  exploits  of  deed  or  word,  that  bring  you  a  mind  of  the 
maniac  and  the  drunkard,  whose  powers  of  judging  are  defective.  A  man 
may  be  entirely  awake  with  the  exception  of  a  single  member ;  and  this  we 
still  refer  to  a  torpid  state  of  some  portion  of  the  brain.  Such  a  man  will 
tell  you  that  his  arm  or  leg  is  asleep  or  dead.  But  as  this  is  a  soporific  subject, 
and  may  have  a  soporific  influence  on  some  of  you,  I  may  as  well  wake  you 
up  with  an  anecdote  a  brother  medical  officer  of  the  army  once  told  me  of 

himself:     While  serving  in  the  East  Indies,  Dr.  C one  night  awoke,  or 

I  should  rather  say  half-awoke  suddenly,  when  his  hand  at  the  instant  came 
in  contact  with  a  cold  animal  body.  His  fears  magnifying  this  into  a  cobra 
capel,  he  called  out  most  lustily,  "  A  snake,  a  snake  !"  But  before  his  drowsy 
domestics  had  time  to  appear,  he  found  he  had  mistaken  his  own  sleeping  arm 
for  this  most  unwelcome  of  oriental  intruders ! 

Gentlemen,  the  human  body  in  health  is  never  asleep  throughout,  for  when 
volition  is  paralysed — when  we  are  all  but  dead  to  everything  that  connects  us 
with  the  external  world,  the  heart  still  continues  to  beat,  the  lungs  perform 
their  office,  and  the  other  internal  organs,  over  which  volition  has  no  control, 
keep  on  their  usual  harmony  of  motion ;  in  other  words,  the  digestion  of  the 
food,  the  circulation  of  the  blood,  and  the  other  lesser  motions  of  organic  life, 
proceed  as  in  the  waking  state.  The  more  important  motions  of  the  heart 
and  lungs  could  not  cease  for  many  minutes  without  endangering  the  entire 
life  in  the  higher  animals ;  though  these  organs  in  the  bat,  dormouse,  and 
snake,  appear  to  be  inactive  for  months.  Nevertheless,  even  in  those  ani- 
mals, they  are  not  entirely  so ;  the  wasted  state  of  their  bodies,  when  they 
wake,  proving  the  movement  that  had  been  going  on  in  all  the  atoms  of  their 
various  organs  during  the  period  of  hybernation.  The  state  termed  a  fainting 
fit,  it  is  true,  comprehends,  even  in  man,  a  temporary  palsy  or  death  of  the 
whole  body ;  but  such  state  prolonged  to  a  very  brief  period  passes  into 
death  perpetual.  Catalepsy,  or  trance,  being  a  sleep  of  all  the  organs,  in- 
ternal as  well  as  external,  though  not  of  their  atoms,  has  so  great  a  .resem 
blance  to  death,  as  to  have  been  frequently  mistaken  for  it.  The  subject  of 
this  condition  of  body,  by  something  like  the  same  inexplicable  power  which 
enables  the  dormouse  to  hybernate,  may  remain  apparently  dead  for  days, 
and  yet  recover.  More  inexplicable,  still,  if  what  travellers  tell  us  be  true,  is 
the  recovery  to  life  of  fish,  that  have  been  completely  frozen  for  months. 

We  now  pass  to  the  consideration  of  those  alterations  of  the  temperature, 
and  periodic  movements  of  the  body,  termed 

Disease  or  Disorder. 

Till  the  hour  of  sickness  comes,  how  few  non-medical  persons  ever  think 
of  a  subject  which  ought  to  be  of  interest  to  all !  The  same  men  who  dis- 
cuss with  becoming  gravity,  the  artificial  inflections  of  a  Greek  or  Latin 
verb,  neglect  to  inform  themselves  of  the  natural  laws  that  govern  the  mo- 
tions of  their  own  bodies !  No  wonder  that  the  world  should  be  so  long  kept 
in  darkness  on  medicine  and  its  mode  of  action, — no  wonder  that  even  edu- 
cated persons  should  still  know  so  little  of  the  proper  study  of  mankind — 
man  !  In  the  throes  of  disease,  the  early  priests,  as  I  have  already  told  you, 
imagined  they  detected  the  workings  of  demons.  Medical  theorist*,  on  the 
contrary,  attribute  them  to  morbid  ingredients  in  the  blood  or  bowels.  One 
age  bowed  the  knee  to  an  "  acrimony"  or  "putridity;"  another  acknow- 
ledged no  cause  but  a  "humour."  The  moderns  bold  the  notion  that  a  mvs- 
terious  process,  which  they  term  "inflammation,"  is  the  head  and  front"  of 
all  offending.  How  absurd  each  and  all  of  these  doctrines  will  appear  in  the 
sequel !     Disease,  Gentlemen,  is  neither  a  devil  to  "  cast  out,"  an  acrimony 


LECTURE  I.  3) 

or  crudity  to  be  expelled,  nor  any  fanciful  chemical  goblin  to  be  chemically 
neutralised  ; — neither  is  the  state  erroneously  termed  inflammation,  so  com- 
monly the  cause  as  a  coincident  part  of  general  disorder.  Disease  is  an  error 
of  action — a  greater  or  less  variation  in  the  motion,  rest,  and  revolutions  of 
the  different  parts  of  the  body — reducible,  like  the  revolutions  of  Health,  into 
a  systematic  series  of  periodic  alternations.  Whatever  be  the  cause  or  causes 
of  corporeal  aberration,  in  obedience  to  the  law  of  all  matter,  the  first  effects 
are  change  of  motion  and  change  of  temperature.  The  patient  accordingly 
has  a  feeling  of  heat  or  cold.  His  muscular  movements  less  under  the  con- 
trol of  their  respective  influences,  become  tremulous,  spasmodic  ;  or  wearied, 
palsied,  the  functions  of  particular  muscles  cease.  The  breathing  is  hurried 
on  slight  exertion ;  or  it  is  maintained  slowly  and  at  intervals,  and  with  a 
long  occasional  inspiration  and  expiration — familiar  to  you  ah  in  the  act  of 
sighing.  The  heart  is  quick,  palpitating ;  or  languid,  or  remittent  in  its 
beats ;  the  appetite  craving,  capricious,  or  lost.  The  secretions  are  either 
hurried  and  increased  in  quantity  ;  or  sluggish,  or  suppressed.  The  body 
shows  a  partial  or  general  waste  ;  or  becomes  in  part  or  in  whole  preternatu- 
rally  tumid  and  bloated.  Alive  to  the  slightest  stimulus,  the  patient  is  easily 
impassioned  or  depressed  ;  his  mind,  comprehending  in  its  various  relations 
every  shade  of  unreasonable  sadness  or  gaiety,  prodigality  or  cupidity,  vacil- 
lation or  pertinacity,  suspicious  caution  or  too  confident  security  ;  with  every 
colour  of  imagination,  from  highly  intellectual  conception  to  the  dream-like 
vagaries  and  reveries  of  hallucination.  His  sensations  are  perceptibly  dimi- 
nished or  increased.  Light  and  sound,  for  example,  confuse  or  distract  him ; 
like  the  soft  Sybarite,  a  ruffled  rose-leaf  frets  him.  With  the  smallest  in- 
crease in  the  medium  temperature  of  the  atmosphere,  he  becomes  hot  and 
uncomfortable,  and  the  slightest  breeze  shivers  and  discomposes  him ;  or,  as 
you  may  sometimes  observe  in  the  case  of  extreme  age  or  idiocy,  he  becomes 
equally  insensible  to  excess  of  light,  sound,  heat,  and  cold. 

Contrast,  if  you  please,  these  simpler  forms  of  Disease  with  what  we 
have  said  of  Health,  and  you  will  at  a  glance  perceive  that  the  difference 
betwixt  the  two  states  consists  in  mere  variation  of  the  sum  or  amount  of 
particular  corporeal  motions,  and  in  a  difference  of  effect  of  external  agency 
on  the  matter  and  functions  of  the  body.  Structural  change,  or  tendency  to 
decomposition  of  any  part  of  the  frame,  so  frequently  but  erroneously  associ- 
ated with  disease  as  a  cause,  is  not  even  a  necessary  element  in  a  fatal  result. 
What  are  Toothache,  Consumption,  Rheumatism,  but  developments  of  consti- 
tutional change  ? — they  are  phenomena  which  may  or  may  not  arise  out  of 
general  corporeal  disturbance,  according  to  particular  habits  and  predisposition. 
J3y  predisposition,  I  mean  the  readiness  or  fitness  of  one  part  of  the  body  more 
than  another  to  be  acted  upon  by  influences  from  without, — occasioned  by  a 
weakness  in  the  cohesive  power  of  the  atoms  of  that  part  to  each  other.  We 
have  all  our  particular  predispositions. 

Let  us  now  inquire  into  the 

Causes  of  Disease. 
What  are  the  agencies  that  give  rise  to 

"  Maladies 

Of  ghastly  spasms,  or  racking  tortures,  qualms 
Of  heart-sick  agony,  all  feverish  kinds, 
Convulsions,  epilepsies,  fierce  catarrhs, 
Intestine  stone,  and  ulcer,  colic  pangs, 
Demoniac  phrenzy,  moping  melancholy 
And  moonstruck  madness,  pining  atrophy, 
Marasmus,  and  wide-wasting  pestilence, 
Dropsies  and  asthmas,  and  joint-racking  rheums  ?" 
\  Milton. 

Gentlemen,  the  Causes  of  all  these  various  diseases — Various  in  name, 


S 


32  LECTURE  I. 

place,  and.  degree — One  only  in  their  real  nature — may  be  found 
either  in  a  deprivation  or  wrong  adaptation  of  the  identical  forces  which  con- 
tinue Life  in  health, — the  same  natural  agencies,  in  a  word,  by  which  every 
motion  or  event  is  produced  throughout  the  universe.  They  comprise,  there- 
fore, everything  that  connects  us,  directly  or  indirectly,  with  the  external  world ; 
and  most,  if  not  all  of  them,  act  upon  us,  in  the  first  place,  through  the  dif- 
ferent modifications  of  nervous  perception.  The  causes  of  disease,  then, 
never  originate  in  any  one  organ  of  the  body, — except  in  so  far  as  that  organ 
may  be  predisposed  by  an  inherent  weakness  of  the  attractive  power  of  the 
atoms  of  its  parts,  to  receive  grave  impressions  from  outward  agencies  that 
affect  the  more  stable  portions  of  the  same  body  in  a  slighter  manner.  I  con- 
ceive with  Hobbes,  that,  "nothing  taketh  beginning  from  itself,  but  from 
the  action  of  some  immediate  agent  witiwut  itself."  If  this  be  true,  how  de- 
lusive the  idea  of  those  professors  who  look  for  the  Causes  of  disease  in  the 
bodies  of  the  dead  !  In  the  schools  we  constantly  hear  that  Anatomy  is  the 
foundation  of  medical  science.  Sydenham,  on  the  contrary,  held  it  so  cheap, 
as  to  say,  "  Anatomy  is  a  fit  study  for  painters  ;" — he  might  have  added,  and 
also  for  surgeons  ;  but  so  far  as  Medicine  is  concerned,  the  best  anatomists 
have  been  seldom  good  physicians.  They  have  been  all  too  mechanical  in 
their  notions.  Do  not,  Gentlemen,  for  a  moment  suppose  I  mean  to  condemn 
the  study  of  Anatomy,  or  that  I  would  desire  to  leave  it  out  in  any  system 
of  medical  education.  Cultivated  in  a  proper  spirit,  I  would  rather,  on  the 
contrary,  make  it  a  part  of  the  useful  education  of  the  people.  By  surgeons 
Anatomy  must  be  studied  minutely,  and  few  men  in  these  days  would  care 
to  practise  Physic  without  possessing  a  competent  knowledge  of  the  various 
organs  of  the  body  on  which  medicines  operate.  But  let  the  student  keep  in 
mind  that  a  dead  body  is  one  thing  and  a  living  body  another — and  that  a 
man  may  know  anatomy  as  well  as  the  best  professor  who  ever  taught  it, 
and  yet  be  utterly  ignorant  what  medicines  to  prescribe  if  he  wished  to  alter 
the  motions  of  any  one  organ  of  a  living  body.  To  Physic,  anatomy  is  a 
mere  accessary — and  the  Physicians  of  some  countries,  India  and  China  for 
example,  practise  their  profession  with  wonderful  success,  though  they  never 
saw  the  inside  of  a  dead  body.  Sydenham  is  called  to  this  day  the  EngU/h 
Hippocrates,  and  yet  you  have  seen  how  little  he  prized  anatomy. — And. 
certainly,  in  his  own  words,  it  is  a  knowledge  "  easily  and  soon  attained,  and 
it  may  be  shortened  more  than  other  things  that  are  more  difficult,  for  it  may 
be  learned  by  sight  in  human  bodies,  or  in  some  animals,  and  that  very 
easily,  by  such  as  are  not  sharp-witted,"  [meaning,  thereby,  that  any  block- 
head with  a  tolerable  memory  may  easily  master  it.]  "  But  in  acute  diseases," 
he  continues,  "  which  kind  contains  more  than  two-thirds  of  diseases  ;  and 
moreover,  in  most  chronic  complaints,  it  must  be  confessed  there  is  some 
specific  property"  [depending,  as  I  shall  afterwards  show  you,  on  the  elec- 
trical condition  of  the  living  brain,]  "  which  no  contemplation  deduced  from 
the  speculation  of  the  [dead]  human  body  can  ever  discover  : — wherefore, 
that  men  should  not  so  place  the  main  of  the  business  upon  the  dissection  of 
carcasses,  as  if  thereby  the  medical  art  might  be  rather  promoted,  than  by  the 
diligent  observation  of  the  natural  phenomena,  and  of  such  things  as  do 
and  hart" — the  action  of  medicine,  for  example,  and  other  external  B| 
upon  thft  living.  How  different  this  from  the  language  of  Dr.  Baillie,  who 
6ays,  "  The  dead  body  is  that  great  basis  on  which  wc  are  to  build  the 
knowledge  that  is  to  guide  us  in  distributing  life  and  health  to  our  fellow- 
creatures !"  Here,  then,  so  far  as  mere  authority  goes,  you  have  the  opi- 
nions of  two  celebrated  men  in  direct  opposition.  But  in  the  course  of  these 
lectures,  I  will  give  you  something  bettor  than  aliy  human  authority,  how- 
ever respectable. 

The  too  exclusive  spirit  in  which  professor*  hivs  urged  the  uecossity  of 
investigating  the  bodies  of  the  dsarl,  not  in  England  cuily,  but  throughout 
Europe,  has  given  rise  to  a  class  of  medical  materialists,  who,  hoping  to  6*>d 


LECTURE      I.  33 

the  origin  of  every  disease  made  manifest  by  the  scalpel,  are  ever  mistaking 
effects  for  causes.  Loth  to  believe  that  death  may  take  place  without  even 
a  palpable  change  of  structure,  these  individuals  direct  their  attention  to  the 
minutire  of  the  dead — and  finding,  in  their  search,  some  petty  enlargement, 
some  trifling  ulceration,  or,  it  may  be,  some  formidable  tumor  or  abscess, 
hastily  set  this  down  as  the  first  cause  of  a  general  disease  of  which  it  waa 
onby  a  development  or  coincident  part.  "  These  people,"  in  the  words  of 
the  late  Dr.  Uwins,  "  put  consequence  for  cause,  incident  for  source,  change 
in  the  condition  of  blood  vessels  for  powers  producing  such  change.  It  is  an 
error  which  has  its  origin  in  the  blood  and  filth  of  the  dissecting-room,  and 
which  tends  to  degrade  medicine  from  the  dignity  of  a  science  to  the  mere 
detail  of  an  art."  What  has  practical  medicine  gained  at  the  hands  of  ana- 
tomical professors  ?  The  greater  number  of  their  pupils  have  been  sceptics 
in  Physic ;  and  no  wonder,  since  they  have  been  so  constantly  accustomed 
to  hear,  ex  cathedra,  that  anatomy  is  the  foundntion  of  all  medical  science. 
That  were  true  enough,  if  by  the  word  '•  foundation"  be  meant  that  anatomy 
is  the  lowest  part  of  it.  The  fact  is,  this  kind  of  language  is  the  natural  re- 
sult of  a  too  great  preponderance  of  Surgical  influence  in  the  schools.  It  is 
the  effect  of  a  too  great  influence  of  your  •■•  great  operators," — tending  to 
make  young  men  expert  anatomical  mechanics,  but  nothing  more.  These 
leave  their  universities,  not  only  with  a  contempt  for  Physic,  but  without  a 
single  correct  idea  of  the  action  of  medicine  on  the  living  system  ;  and  yet  to 
these  the  people  of  this  country  chiefly  entrust  the  treatment  of  their  dis- 
eases, which,  in  ninety-nine  cases  out  of  the  hundred,  demand  medical,  not 
surgical  knowledge  for  their  cure.  Beware,  then,  of  trusting  to  great  opera- 
tors, to  men  whose  art  Shakspeare  truly  says  has  "  no  honour  in  it," — for 
were  Physic  better  cultivated,  there  would  be  little  need  of  such  an  oppro- 
brium in  medicine  as  operative  mutilation.  It  is  an  art,  too, -that  blunts  the 
feelings  and  inclines  its  professors  too  often  to  use  the  knife  more  to  gratify 
their  own  love  of  display,  than  to  give  relief  te  their  suffering  fellow-crea- 
tures. No  "great  operator"  should  be  permitted  to  perform  any  capital 
operation  without  the  previous  consent  of  one  or  more  physicians.  In  its 
present  mechanical  and  degraded  state,  who  can  wonder  that  those  who 
practise  Medicine  should  so  frequently  cut  the  sorry  figures  they  do  when 
examined  as  witnesses  in  our  courts  of  law,  or  that  their  evidence  in  most 
instances  should  appear  to  both  the  Bench  and  Bar  a  tissue  of  incoherency 
and  inconsistency  throughout  ?  At  an  inquest,  medical  practitioners  seldom 
get  beyond  the  appearances  of  a  post  mortem  examination,  though  in  a  great 
many  instances  such  appearances,  as  I  shall  afterwards  show  you,  have  been 
produced  by  their  own  bad  practice !  It  is  somewhat  strange  that  their  too 
numerous  opportunities  of  dissecting  dead  bodies  should  not  long  ago  have 
opened  their  eyes  to  their  paucity  of  resource  for  the  ailments  of  the  living! 
So  great  and  universal  has  the  prevalent  delusion  upon  the  subject  of  dissec- 
tion become,  that  almost  everybody,  from  tire  peer  to  the  peasant,  shares  in 
it.  Lord  Brougham,  in  a  speech  he  once  made,  declared  that  "the  only 
good  medical  education  is  to  be  got  in  the  dissecting-room."  The  same  no- 
bleman, in  his  work  on  Natural  Theology,  speculates  upon  the  power  of 
mind  apart  from  matter;  proving  himself  to  be  equally  superficial  in 
mental  as  in  medical  science.  But  what  advantages,  let  me  ask,  have  cen- 
turies of  dissection  contributed  to  the  healing  art  ?  We  hear  of  a  great 
many,  truly ;  but  lungs  decomposed,  livers  enlarged,  bone,  muscle,  and  in- 
testine in  various  stages  of  corruption,  would  seem  to  comprise  the  whole. 
These  are  nevertheless  what  modern  professors  put  up  in  bottles  and  cases, 
and  exultingly  show  off  as  "  beautiful  specimens!"  "superb  collections!" 
pointing  them  out  at  the  same  time  to  their  credulous  pupils  as  the  trophies 
of  science,  when  they  might  better  describe  them  as  the  triumphs  of  death 
over  their  own  want  of  skill ;  or, — in  the  words  of  Gray, 

"  Rich  windows  that  exclude  the  light, 
And  passages  that  lead  to  nothing .'"        *  d 


34  LECTURE  I. 

Now,  what  has  the  most  patient  study  of  these  done  for  Physic  ?  has  it 
given  us  one  new  remedy,  or  told  us  better  how  to  use  our  old  ?  Where 
were  the  virtues  of  bark  and  opium  ascertained  ?  In  the  dead  house  ?  No, 
certainly  !  The  one  was  discovered  by  a  Peruvian  peasant  who  cured  him- 
self of  the  ague  by  it  :  what  had  anatomy  to  do  with  that  ?  For  the  other 
we  may  thank  the  Brahmins  of  Hindustan,  who  hold  the  dissecting-room  in 
horror.  Antimony,  rhubarb,  mercury, — whence  got  we  our  knowledge  of 
these  ? — From  the  quack  and  the  old  woman — individuals  who  will  ever  suc- 
cessfully compete  with  physicians,  while  the  latter  busy  themselves  with 
dead  bodies,  to  the  neglect  of  the  powers  and  principles  that  affect  the  living. 
"  A  cripple  in  the  right  way,"  says  Lord  Bacon,  "  will  beat  a  racer  in  the 
wrong."  So  great  a  stumbling-block  to  a  proper  knowledge  of  medicine  has 
been  this  exclusive  and  too  minute  attention  to  dissection,  that  Dr.  Baillie, 
its  greatest  patron,  after  retiring  from  practice,  confessed,  as  I  have  already 
told  you,  his  total  want  of  faith  in  physic.  The  experience  of  his  whole  life 
was  equally  a  satire  on  anatomical  knowledge,  and  the  value  too  often  attach- 
ing to  a  medical  reputation. 

To  return  to  the  causes  of  disease, — are  they  not  infinite  ?  The  seasons 
and  the  sidereal  influences ;  the  earth  and  its  emanations ;  the  air  and  its 
electrical  conditions ;  the  degrees  of  temperature,  dryness,  and  moisture  of 
surrounding  media ;  the  nature  and  extent  of  our  food  and  drink ;  the 
passions  by  which  we  are  agitated,  with  all  the  other  changes  and  chances 
of  our  social  and  individual  position ;  these  are  the  elements  to  which  we 
must  look  not  Only  for  the  causes  of  disorders,  but  for  the  causes  of  health 
itself. 

Having  alluded  to  the  great  error  of  the  "  anatomical,"  or,  as  it  is  some- 
times called,  the  "  pathological"  school,  we  may  now  glance  at  the  doctrines 
of  another  class  of  partialists,  those  who,  with  the  quantity  or  quality  of  our 
food  or  airs,  associate  every  disorder, — as  if  passions,  burns,  blows,  wounds, 
&c,  were  mere  words.  The  late  Mr.  Abernethy,  to  whom  science,  never- 
theless, owes  something,  was  an  example  of  the  first.  To  the  stomach  and 
bowels,  he  almost  invariably  pointed  as  the  first  cause  of  every  disturbauce. 
He  forgot  his  own  observation,  that  a  passion,  or  blow,  will  alter  the  secre- 
tions of  both.  He  ascribed  the  first  link  in  the  chain  of  causes  to  a  feature, 
which  could  only  be  improved  by  an  agent  affecting  the  nervous  or  percep- 
tive system,  in  which  that  and  every  other  symptom  could  alone  have  their 
origin. 

But  what  shall  we  say  of  those  who,  like  M'Culloch  and  others,  attribute 
every  disorder  in  which  remittency  of  symptom  tak(.s  place  to  marsh-miasma 
or  malaria, — to  exhalations  from  the  fens,  marshes,  &c.,— when,  as  we  shall 
shortly  show,  every  disease  which  has  obtained  a  name,  may  not  only  admit 
of  this  phenomenon  ;  but  that  none,  by  whatever  caused  or  characterised,  are 
in  the  first  instance  without  their  remissions  or  intermissions,  all  more  or  less 
periodic  and  perfect.  Man  is  llbt  an  isolated  being;  without  air  nr  food  he 
cannot  exist;  and  a  partial  deprivation  or  depravity  of  either,  will  give  rise- 
to  almost  every  affection  to  which  he  is  liable  ;  but  his  success  in  life,  his  re- 
ception from  friend  and  foe,  the  state  of  family  or  finances,  will  equally  excite, 
depress,  and  disorder  his  various  organs  and  functions,  as  a  deprivation  or  de- 
pravity of  the  food  be  eats,  or  the  air  he  breathes.  An  unexpected  reverse 
of  fortune,  good  or  bad,  may  lay  the  foundation  of  a  thousand  maladies :  nay, 
examples  are  on  record,  where  individuals  have  instantly  expired  from  in- 
tensity of  sudden  joy.     Of  sudden  grief  many  h*ve  D!  en  the  victim-. 

"  It  has  been  too  much  the  fashion  in  philosophy."  says  Sir  Humphrey 
Davy,  >(  to  refer  operations  and  effects  to  tingU  agencies,  bur  there  are,  in 
fact,  in  nature  two  grand  species  of  relationship  between  phenomena;  in  one 
an  iiil'mite  variety  of  effects  is  produced  by  a  single  cause, — in  the  other,  a 
great  variety  of  causes  is  subservient  to  om  effect."  This  observation  applies 
with  particular  force  to  everything  pertaining  both  to  the  causes  of  disease 


LECTURE  I.  35 

and  its  cure.  The  single  agency  of  thermal  change,  for  example,  has  given 
rise  to  cough,  catarrh,  rheumatism,  dropsy,  and  a  host  of  other  disorders  in 
one  class  of  individuals;  while  in  another  class,  to  call  forth  any  one  of  such 
states,  it  would  require  the  united  influence  of  intemperance,  domestic 
trouble,  and  deprivation  of  food,  in  addition  to  that  thermal  change,  which  of 
itself  singly  produced  all  these  diseases  in  the  former.  Physicians  are  in  the 
habit  of  dividing  diseases  into  two  classes,  namely,  constitutional  and  local,  and 
they  treat  them  as  such  accordingly  ;  but,  properly  speaking,  there  never 
was  a  purely  local  disease.  You  will  doubtless  ask  me  if  toothache,  con- 
sumption, and  ulcers,  are  not  local  diseases  ?  So  far  from  this,  it  is  impossi- 
ble for  such  states  to  take  place,  (unless  where  they  happen  to  be  produced 
by  outward  injury,)  without  the  previous  condition  of  entire  constitutional 
disturbance, — of  which,  instead  of  beinn;  causes,  as  many  suppose  and  teach, 
they  are  only  effects  or  features.  Let  the  physician  recur  to  nature,  he  will 
find  that  the  subjects  of  all  such  diseases  laboured  under  a  general  derangement 
of  the  whole  habit,  previously  to  the  development  of  the  local  consequences 
from  which  these  diseases  take  their  designations.  Now,  some  will  call  this 
disturbance  by  one  name,  and  some  by  another  ;  for  myself,  I  am  satisfied 
with  the  phrase,  "  loss  of  health,"  but  as  many  of  you,  Gentlemen,  may  not 
be  content  without  a  medical  term,  I  will  call  it,  to  please  you,  Fever";  and 
as  remissions  or  periods  of  comparative  ease  are  enjoyed  by  the  subjects  of 
all  these  diseases,  I  will  go  farther,  and  call  it  Remittent  Fever.  Yes, 
Gentlemen,  all  diseases  have  remissions,  and  "  this,"  says  John  Hunter,  "  is 
an  attribute  belonging  to  life,  and  shows  that  life  cannot  go  on  the  same  con- 
tinually, but  must  have  its  hours  of  rest  and  hours  of  action." 

We  have  already  analyzed  the  Life  of  Health  ; — we  have  seen  that  it  con- 
sists in  a  periodic  alternation  of  harmonious  movements,  some  long,  some 
short, — greater  and  lesser  movements,  otherwise  fits  ;  in  Shakspeare's  lan- 
guage, Life  is  a  "fitful  Fever."  If  so,  what  can  the  morbid  modifications 
of  that  Life  be,  but  modifications  of  Fitful  or  Intermittent  Fever  ?  "  All 
diseases,"  says  Hippocrates,  "  resemble  each  other  in  their  form,  invasion, 
march,  and  decline."  "  The  type  of  all  diseases,"  he  adds,  "  is  one  and  the 
same."  What,  then,  is  that  type  ?  If  we  succeed  in  proving  to  you  that 
toothache,  asthma,  epilepsy,  gout,  mania,  and  apoplexy,  all  come  on  in  fits  ; 
that  all  have  febrile  chills  or  heats  ;  that  inter missions  or  periods  of  immuni- 
ty from  suffering,  more  or  less  complete,  are  common  to  each  ;  and  that 
every  one  of  these  supposed  different  diseases  may,  moreover,  be  cured  by 
any  one  of  the  agents  most  generally  successful  in  the  treatment  of  Intermit- 
tent Fever,  popularly  termed  Ague  ;  to  what  other  conclusion  can  we  pos- 
sibly come,  but  that  this  same  Ague  is  the  type  which  pervades,  and  the 
bond  which  associates  together  every  one  of  these  variously  named  diseases  ? 
If,  in  the  course  of  these  Lectures,  we  further  prove  that  what  are  called 
"  inflammations"  also  come  on  in  fits  ;  that  the  subjects  of  them  have  equally 
their  periods  of  immunity  from  pain,  and  that  these  forms  of  disorder  yield 
with  equal  readiness  to  the  same  remedial  means  ; — who  can  be  so  unreason- 
able as  to  doubt  or  dispute  that  Ague  is  the  model  or  likeness — the  type  of 
all  disease  ! 

But  here  let  me  be  clearly  understood  ; — let  me  not  be  supposed  to  say 
that  every  disease  is  an  ague  and  nothing  more.  A  canoe  is  the  model  of  all 
sea-vessels, — the  type  of  every  brig,  barque,  frigate,  sloop,  and  so  forth, 
nautically  termed  ship.  But,  a  ship  is  a  canoe,  and  something  more — a 
canoe  enlarged  and  variously  modified.  Here,  then,  you  have  unity  of 
type  with  variety  of  developement, — simplicity  of  principle  with  numerous 
modifications  of  form.  This  is  what  I  wish  to  impress  upon  you  in  the  case 
of  Disease.  Let  that,  then,  be  your  motto  and  your  mark,  and  do  not  forget 
it  in  the  practical  application.  Remember  the  constantly  changing  pheno- 
mena of  Health, — their  FEVER-like  fit-fulness, — the  slow  manner  in  one  case, 
the  rapid  manner  in  another,  in  which  these  healthy  fitful  motions  run  into 


36  LECTURE  I. 

motions  unhealthily  fitful, — run  into  the  true  ague  or  agueish  fits,  with  which 
I  shall  hereafter  prove  to  you  all  diseases  commence.  And  beware  of  mis- 
taking the  end  for  the  beginning, — the  consequence  or  coincidence  for  the 
cause  ;  beware  of  that  all  but  universal  medical  error — that  fallacy  in  many 
instances  so  fatal — of  mistaking  the  decay,  or  tendency  to  decay,  of  a  part, 
for  the  primary  causs  of  the  febrile  disturbance  of  the  whole  ; — when,  as 
by  numerous  proofs,  I  shall  bring  it  home  to  your  conviction  that  such  local 
disease,  in  the  majority  of  instances,  is  a  mere  consequence  or  developement 
simply, — a  termination  or  effect,  though  sometimes  a  coincidence  from  the  be- 
ginning* of  repeated  constitutional  febrile  attacks.  Health  and  Disease, 
Gentlemen,  are  convertible  states  ; — else  why  should  the  aid  of  the  physician 
be  asked  ?  The  same  moving  matter  of  the  body,  when  influenced  by  one 
agency,  may  become  Disease,  and  acted  upon  by  another  while  in  the  dis- 
eased state,  may  return  again  to  the  condition  of  Health. 

The  human  body,  whether  in  health  or  disorder,  is  an  epitome  of  every 
great  system  in  nature.  Like  the  globe  we  inhabit,  it  has  in  health  its  diur- 
nal and  other  revolutions  ;  its  sun  and  its  shade  ;  its  times  and  seasons  ;  its 
alternations  of  heat  and  moisture.  In  disease,  we  recognise  the  same  Jong 
chills  and  droughts, — the  same  passionate  storms  and  outpourings  of  the 
streams,  by  which  the  earth  at  times  is  agitated, — the  matter  of  the  body 
assuming  in  the  course  of  these  various  alternations,  changes  of  character 
and  composition,  such  as  abscesses,  tumours,  and  eruptions,  typical  of  new- 
formed  mountain  masses,  earthquakes,  and  volcanoes ;  all  these,  too,  like  the 
tempests  and  hurricanes  of  nature,  intermitting  with  longer  or  shorter  periods 
of  tranquillity,  till  the  wearied  body  either  regains,  like  our  common  mother, 
its  wonted  harmony  of  motion  ;  or,  like  what  we  may  conceive  of  a  world 
destroyed,  becomes  resolved  into  its  pristine  elements. 

In  the  language  of  the  schools,  the  phases  of  Disease  are  termed  the 
Paroxysm  and  Intermission ;  the  first,  or  period  of  suffering,  being  synony- 
mous with  access,  exacerbation,  throe,  fit ;  the  second,  as  we  have  already 
seen,  meaning  the  period  or  interval  of  comparative  freedom  from  disorder  ; 
though  when  less  completely  periodic,  Intermission  is  usually  termed  Remis- 
sion. For  my  own  part,  I  shall  occasionally  be  compelled  to  use  Remission 
and  Intermission  synonymously.  But  as  I  have  already  explained  to  you, 
so  far  from  having  been  recognised  as  a  law  of  universal  occurrence,  and 
harmonising  with  every  thing  which  we  know  of  our  own  or  other  worlds, 
periodic  intermission  and  return  have  been  vaguely  supposed  to  stamp  the 
disorders  where  they  were  too  striking  to  be  overlooked,  as  the  exclusive 
offspring  of  a  malarious  or  miasmatic  atmosphere  !  Gentlemen,  there  can  be 
no  greater  error  than  this.  The  actions  of  life  in  health  are  all,  as  you  have 
seen,  periodic  ;  and  however,  or  by  whatever  caused,  their  morbid  modifica- 
tions, termed  disease,  are  periodic  also. 

What  are  the  remedies  most  influential  in  preventing  the  return  of  an 
Ague-fit  ?  The  profession  will  answer,  and  rightly  answer,  the  Peruvian 
bark  ;  or  its  better  substitute,  quinine,  in  fact,  its  essence,  arsenic,  and 
opium;  to  which  you  will  permit  me  to  add  hydrocyanic  acie,  better 
known  as  Prussic  Acid,  iron,  silver,  copper,  strychnia,  musk,  4SSAFK> 
tida,  valerian,  colchicum,  zinc,  BISMUTH,  turpentine;  and  there  are 
others,  doubtless,  in  nature,  which  time  and  accident  may  yet  discover. 
These  agents,  Gentlemen,  are  generally  most  effective  when  taken  during 
the  intermission.  From  the  relation  which  their  influence  must  thus  bear  to 
Time  or  Period,  and  Tem/><  rulur/  (Cold  and  Heat,).!  term  them  (jikono- 
thi.iimal — /oovog  (Chronos)  being  the  Greek  word  for  Time — f'fji'i,  (Ther- 
ms) for  Heat  or  Temperature.  But  ns  some'  of  you,  in  common  with  many 
in  the  profession,  and  not  a  few  out  of  it,  may  possibly  be  sceptical  in  regard 
to  the  curative  power  of  any  medi  be  in  any  disease,  I  will  here  tell  you 
how  I  lately  settled  this  matter  with  a  certain  young  barrister,  who  thought 
he  should  be  able  to  prove  to  me  that  physic  is  all  nonsense.     "  Do  you 


LECTURE  I.  37 

mean  to  tell  mc,"  said  the  gentleman  in  question,  "  that  putting  little  bits  of 
pounded  stick  or  stone  into  a  man's  stomach,  will  cure  any  disease  whatever  .'" 
"  Oh  !  certainly  not,"  said  I  ;  for  when  you  find  people  obstinate,  it  is  better 
to  humour  them  a  little  at  first;  "but  perhaps,"  I  continued,  "you  may 
just  be  disposed  to  admit,  that  little  bits  of  pounded  stick  and  stone  may 
cause  disease,  and  even  death  ; — otherwise  you  must  be  ready  to  swallow 
hemlock  and  arsenic  in  any  quantity  required  of  you."  To  this  the  man  of 
law  at  once  put  in  a  demurrer.  The  causing  and  killing  part  of  the  business 
he  could  not  by  any  sophistry  get  rid  of.  So  I  then  thought  it  time  to  ex- 
plain to  him,  as  I  now  do  to  you,  that  the  principle  upon  which  these  sub- 
stances can  cute  and  cause  disease  is  one  and  the  same;  namely,  their 
power,  for  good  or  for  evil,  as  the  case  may  be,  of  electrically  altering  the 
motive  state  of  certain  parts  of  the  body,  and  of  altering  at  the  same  time 
their  thermal  conditions. 

Gentlemen,  turn  over  the  history  of  medicine,  and  mark  well  the  remedies 
upon  which  authors  dilate  as  being  most  beneficial  in  any  form  of  disease  ; 
you  will  find  them  to  be,  one  and  all.  agents  having  the  power  of  controlling 
Temperature, — of  exalting  or  depressing  this  in  the  stages  of  exacerbation,  or 
of  continuing  and  prolonging  the  more  healthy  and  moderate  degrees,  of  it, 
characteristic  of  the  period  of  remission  ;  thereby  at  the  same  time  control- 
ling motion,  or  vice  versa. 

For  this  latter  indication,  the  most  generally  efficient  of  all  remedies  is  the 
Peruvian  Bark,  or  Quinine  ;  but  it  is  not  specific,  nor  is  there  such  a  thing 
as  a  specific,  for  this  or  any  other  purpose,  in  physic  ;  arsenic,  opium,  hydro- 
cyanic acid,  all  proving  better  or  worse  than  another  in  particular  cases  of 
disease,  and  this  less  with  reference  to  the  disorder  and  its  cause,  than  to  the 
constitution  or  peculiarity  of  system  of  individual  patients.  This  peculiari- 
ty, Ave  shall  afterwards  prove,  depends  upon  certain  Electrical  conditions  of 
the  Brain.  But  upon  the  nature  and  the  mode  of  action  of  all  Remedial  sub 
stances,  we  shall  enter  at  length,  at  a  more  advanced  period  of  the  course. 
In  our  next  lecture  we  shall  consider  the  phenomena  of  ague,  and  show  you 
its  relation  to  Spasmodic  disease, — Asthma,  Epilepsy, — to  Palsy,  Curved 
Spine,  Squint,  &c.  These  disorders  we  shall  prove  are  merely  so  many  de- 
velopements  occurring  in  its  course, — analytically,  by  rigidly  scrutinising 
their  symptoms ;  synthetically,  by  detailing  to  you  cases  of  each  cured  on 

CHRONO-THERMAL  principles. 


LECTURE  II. 

AGUE — SPASMODIC    AND    PARALYTIC    DISEASE — DISORDERS   OF    SENSATION 

In  our  former  Lecture,  Gentlemen,  you  will  remember  that,  after  a  brief 
allusion  to  a  few  of  the  many  errors  which,  from  time  to  time,  have  prevailed 
in  the  schools,  we  took  a  more  simple,  though,  at  the  same  time,  a  much 
more  bold  and  sweeping  view  of  the  subject  of  Medicine  than  would  appear 
to  have  hitherto  come  within  the  grasp  of  teachers  and  professors.  The  na- 
ture of  Health,  Sleep,  and  Disease,  we  in  some  measure  explained  ;  and  we 
proposed,  as  matter  for  future  argumentation,  that  intermittent  fever  or 
ague  is  the  type,  model,  or  likeness  of  all  the  maladies  to  which  man  is 
liable, — referring,  at  the  same  time,  to  certain  natural  analogies  in  the  world 
around  us  ;  and  hazarding  the  statement,  (which,  until  we  prove,  we  by  no 
means  wish  you  to  take  for  granted)  that  the  chrono-thermal,  or  ague  medi- 
cines, are  the  most  generally  influential  in  the  treatment  of  every  kind  of  dis- 
ease. Let  it  not,  however,  be  supposed  that,  in  our  high  estimate  of  this 
particular  class  of  remedies,  we  reject,  in  practice,  any  earthly  agent  which 


38  LECTURE  II. 

God  has  given  us ;  for  there  is  no  substance  in  nature  which  may  not  be 
turned  to  good  account  by  the  wise  and  judicious  physician.  Besides  the 
chrono-thermal  remedies,  which  we  chiefly  use  as  remedies  of  Prevention, 
we  possess  a  multitude  of  powers  which  have  all  more  or  less  influence  upon 
the  humau  body,  both  in  health  and  disease  :  and  though  few  or  no  substan- 
ces can  act  upon  any  part  of  the  frame  without  implicating  every  other  part, 
yet  do  we  find  that  certain  medicines  have  relations  of  affinity  to  particular 
organs  of  the  body  greater  than  to  others  ;  some  affecting  one  organ,  some  an- 
other. Of  this  class,  Vomits,  Purgatives,  and  Diuretics,  (as  their  names  im- 
port,) Mercury,  Creosote,  Cantharides,  and  the  various  Gums  and  Balsams, 
are  the  principal :  Iodine,  Lead,  the  Earths,  and  Acids  ar%  also  examples. 
But  while,  in  the  more  simple  cases  of  disease,  the  chrono-thermal  medi- 
cines, singly,  may  answer  every  purpose,  particular  cases  of  disorder  will  be 
more  efficiently  treated  with  alternations  and  combinations  of  both  classes, 
than  by  the  exhibition  of  either  simply.  Of  the  action  of  remedies  of  every 
kind,  we  shall  speak  more  particularly  when  we  come  to  treat  of  individual 
substances.  For  the  present,  we  shall  content  ourselves  with  repeating  what 
we  stated  in  our  former  Lecture,  in  connexion  with  this  subject,  that  the 
actiqn  of  remedy  and  cause,  in  every  case,  comes  at  last  to  the  common 
principle  of  their  capacity  to  affect  temperature  or  motion — change  in  one 
never  taking  place  without  change  in  the  other.  It  will  be  a  subject  of  in- 
terest to  pursue  disease  through  all  its  modifications  and  varieties,  step  by 
step,  and  to  show  you  the  source  and  the  extent  of  our  influence  over  it ;  for 
which  purpose  we  shall  call  our  different  witnesses  before  you  in  the  shape  of 
Cases ;  taking  these,  as  often  as  possible,  from  the  experience  of  others,  and  when 
this  fails  us,  from  the  results  of  our  own  practice ;  leaving  to  you,  of  course,  to 
compare  and  cross-examine  these  last  at  your  leisure,  with  such  facts  and  cases 
of  a  similar  description,  as  may  come  before  you  during  your  attendance  at  the 
various  hospitals  with  which  you  are  respectively  connected.  Of  this  we  feel 
assured,  that  whether  or  not  you  individually  pronounce  a  verdict  in  our 
favour  upon  all  counts,  you  will  at  least  collectively  admit,  that  we  have 
compelled  you  to  alter  your  sentiments  most  materially  upon  many  measures 
which  you  previously  supposed  to  be  as  unquestionable  in  practice  as  they 
were  orthodox  in  precept.  But  if,  according  to  Lord  Bacon,  "  disciples  do 
owe  unto  masters  only  a  temporary  belief,  and  a  suspension  of  their  own 
judgment  until  they  be  fully  instructed,  and  not  an  absolute  resignation  or 
perpetual  captivity,"  you  will  not  be  sorry  to  escape  from  the  thraldom  of 
men  who,  when  asked  for  bread,  gave  you  a  substance  which,  in  the  dark- 
ness of  your  ignorance,  you  could  not  by  any  possibility  tell  was  a  stone  ! 
No  longer  mocked  by  mystic  gibberish,  you  will  now  take  your  places  as 
judges  of  the  very  doctrines  you  formerly,  as  pupils,  implicitly  and  without 
examination  believed  ;  and  according  to  the  evidence  which  I  shall  bring  be- 
fore you,  you  will  pronounce  between  your  teachers  and  me — whether  the 
infinity  of  distinctions  and  differences,  upon  which  they  so  pride  themselves, 
be  founded  in  nature  and  reason — or  whether,  in  the  words  of  the  same  great 
philosopher,  "all  things  do  by  scale  ascend  to  unity,  so  then,  always  that 
knowledge  is  worthiest  which  is  charged  with  least  multiplicity." 

Gentlemen,  there  was  a  time  when  the  greater  number  of  people  imagined 
that  the  only  thing  worth  acquiring  in  this  life,  was  a  knowledge  of  the 
dead  languages.  A  new  era  has  since  sprung  up,  and  mankind  have  begun 
to  appreciate  the  advantages  to  be  obtained  from  an  acquaintance  with  the 
chemical  and  physical  sciences.  They  now  prefer  the  study  of  the  natural 
bodies  around  them,  to  pedantic  discussions  about  Greek  artieles  and  Latin 
verbs.  It  is  only  in  the  cloisters  of  Oxford  and  Cambridge,  that  men  sneer 
at  "  utilitarianism,"  or  in  that  antic |uated  ofl'-shoot  of  these  monkish  instirn- 
tions — the  College  of  Physicians.  Railroads,  steamboats,  galvanism,  and  gas, 
have  all  come  to  light  within  the  last  half  century.  A  revolution  in  t! 
and  action  has  been  the  result ;  petty  objects  have  given  way  to  comprehea- 


LECTURE  II.  39 

sive  views,  and  petty  interests  have  been  destroyed  by  the  general  improve- 
ment that  has  already  been  accomplished.  Is  medicine  the  only  branch  of 
human  knowledge  destined  to  stand  still,  while  all  around  it  is  in  motion  1 
Is  the  march  of  intellect  to  sweep  on  and  on,  and  leave  behind  it  this  so- 
called  science,  untouched  and  unimproved  in  its  progress?  When  the 
rhonarchs  who  have  successively  wielded  the  medical  sceptre — who  in  their 
day  were  looked  upon  as  demigods  in  physic,  have  in  turn  declared  that  all 
that  they  knew  of  it  was  that  "  they  nothing  knew,"  shall  blame  be  attached 
to  him  who  would  attempt  to  rescue  his  profession  from  this  worse  than 
darkness  visible  ?  If,  by  their  own  confession,  the  Knightons  and  Baillies 
were  ignorant  of  the  first  principles  of  correct  practice,  surely  it  were  but 
charitable  to  suppose  that  men  so  successful  in  their  worldly  pursuits,  may, 
in  this  instance  at  least,  have  followed  a  deceptive  mode  of  investigation  ? 
Like  the  racer  on  the  wrong  road,  how  could  they,  in  that  case,  get  to  the 
end  of  their  journey  ?  Pursuing  their  professional  studies  chiefly  in  the  dead 
house,  these  physicians  forgot  that  medicine  has  no  power  over  a  corpse. — 
Gentlemen,  the  reflections  which  I  shall  have  the  honour  to  submit  for  your 
consideration,  were  the  result  of  observations  made  on  the  ever-shifting  mo- 
tions of  the  living.  Who  will  tell  me  that  this  kind  of  study  is  only  proper 
for  medical  persons  ?  Who  shall  say  that  this  description  of  knowledge  may 
not  be  made  interesting  to  the  world  at  large  ?  Greek,  Latin,  High  Dutch, 
Hebrew,  —  are  these  representations  of  the  same  Signs,  more  important 
than  an  enlarged  knowledge  of  the  Sense — more  instructive  to  those  who 
pursue  them  as  a  study,  than  a  consideration  of  the  revolutions  and  constantly 
changing  relations  of  the  matter  of  their  own  bodies  ?  Without  a  proper 
knowledge  of  the  laws  of  your  own  organization,  how  can  you  possibly  put 
in  practice  the  good  old  maxim,  "  Know  yourselves  ?" 

Having  premised  this  much,  I  now  come  to  consider  in  detail  the  pheno- 
mena of  Periodic  Fever  commonly  called 

Intermittent  Fever  or  Ague  ; 

for  Ague  being  the  type  of  every  other  modification  of  disease,  it  is  necessary 
you  should  be  well  acquainted  with  the  principal  shades  of  suffering  so  de- 
nominated. I  have  already  told  you  there  can  be  no  disease,  no  morbid  mo- 
tion without  change  of  temperature.  The  subject  of  ague,  then,  among  other 
sensations  and  changes,  successively  experiences  a  Chill  and  Heat,  followed 
by  a  profuse  Perspiration.  These  three  stages,  commonly  called  the  Cold, 
Hot,  and  Sweating  stages,  constitute  the  Paroxysm  or  Fit.  The  patient, 
during  each  stage,  is  in  a  different  condition  of  body  from  either  of  the  others  ; 
his  sensations,  consequently,  differ  during  each  of  them.  To  the  state  of 
Perspiration,  which  terminates  the  fit,  a  periodic  Intermission,  or  regular 
interval  of  comparative  health,  succeeds  ;  and  this  interval  of  immunity  from 
suffering  usually  lasts  one,  two,  or  more  days  (giving  rise  to  the  terms,  Ter  ■ 
tian,  Quartian,  and  other  agues,  according  to  the  duration  of  the  interval), 
before  the  recurrence  of  another  similar  fit ; — such  fit  generally  making  its 
invasion  with  a  wonderful  degree  of  exactness  at  the  same  hour  of  the  clock 
as  the  former,  and  lasting  about  the  same  time, — when  it  is  again  followed 
by  a  similar  periodic  intermission  of  the  symptoms  as  before.  In  every 
stage  of  the  fit,  all  the  functions  of  the  body  are  more  or  less  disturbed. 
During  the  cold  stage,  the  face  becomes  pale,  the  features  shrink,  and  the 
muscles  are  tremulous  or  even  spasmodic  :  the  patient,  in  other  words, 
shivers,  has  cramp,  and  his  strength  is  prostrate.  The  breathing  and  circu- 
lation are  variously  altered, — the  urine,  if  any  passes,  is  generally  pale  and 
plentiful,  and  the  other  secretions  are  similarly  changed  in  quantity  and 
quality.  The  senses  and  mental  powers  are  for  the  most  part  depressed,  or 
even  curiously  vitiated  ;  sometimes,  though  seldom,  they  are  preternaturally 
exalted.     The  patient  has  nausea  and  loss  of  appetite ;  occasionally  sick- 


-10  LECTURE  11. 

ness  ;  less  frequently  looseness  of  bowels ; — or  he  has  hunger  amounting  to 
voracity, — thirst  more  seldom.  A  reaction  now  comes  on.  The  tempera- 
ture of  the  body  gradually  changes  from  cold  to  hot — the  pallor  of  the  face 
gives  place  to  redness — the  cheek  is  now  flushed — the  eye  suffused,  and  the 
patient  suffers  from  headache,  more  or  less  agonising.  This  is  the.  Hot 
6taee. 

The  thirst,  whether  it  existed  before  or  not,  is  now  a  most  prominent  symp- 
tom ;  the  appetite  is  thoroughly  lost;  the  patient  manifesting,  in  must  in- 
stances, a  repugnance  to  the  very  name  of  food.  If  you  inspect  the 
tongue,  you  will  find  it  comparatively  dry  and  loaded,  and  of  a  brown 
colour ;  and  though  the  skin  feel  to  your  hand  like  a  burning  coal,  so  to 
speak,  the  patient  himself  may  complain  of  such  excessive  coldness,  as  to  in- 
duce the  attendants  to  cover  him  with  numerous  blankets  ;  more  generally, 
however,  he  has  a  sensation  of  heat  equally  severe.  Every  muscle  of  his 
body  in  this  stage  is  more  or  less  painful  and  enfeebled  ;  though,  in  some 
instances,  he  may  appear  to  have  a  greater  command  over  them  than  in 
health;  and  if  delirium  supervene,  which  it  may  do.  his  strength  will  appear 
almost  superhuman.  During  the  excitement  of  this  stage,  individuals  have 
been  known  to  become  musical,  poetical,  oratorical,  and  have  exercised  other 
talents  which  they  never  were  known  to  manifest  in  health.  The  heart  now 
beats  violently,  and  the  pulse  is  full  and  bounding;  the  urine,  instead  of  be- 
ing pale  and  plentiful,  as  in  the  preceding  stage,  is  scanty  and  high  coloured. 
The  secretions  generally  are  sluggish,  and  in  some  instances  they  aro  alto- 
gether suppressed.  A  long  Sweat  succeeds,  during  which  the  greater  num- 
ber of  the  suppressed  secretions  gradually  reappear.  As  with  a  feeling  of 
languor,  lassitude,  and  a  disposition  to  yawn,  and  stretch  the  various  mem- 
bers of  the  body,  the  fit  is  usually  preceded ;  so  with  the  same  symptoms 
does  it  usually  end.  Then  comes  the  state  of  comparative  health,  which 
may  either  again  periodically  pass  into  the  Fever-fit,  or  continue  for  an  inde- 
finite space,  so  as  eventually  to  become  Health. 

As  every  individual  has,  from  birth,  some  part  of  his  body  less  strongly 
constructed  than  the  other  parts,  it  would  be  wonderful  indeed,  if,  during 
some  of  the  repetitions  of  this  terrible  tempest  of  body,  termed  an  Ague-fit, 
that  weak  point  were  not  very  often  discovered;  but  discovered,  more  or 
less,  in  most  instances,  it  is.  Is  the  brain  the  least  strongly  constructed 
point  ?  Then,  according  to  the  part  of  the  organ  most  implicated,  and  the 
degree  of  implication,  will  you  have  vertigo,  epilepsy,  apoplexy,  insanity, 
imbecility  of  mind,  palsy,  or  their  shades  superadded.  Is  the  original  weak- 
ness of  conformation  seated  in  the  lungs  ?  Look,  then,  for  spitting  of 
blood,  asthma,  or  consumption.  In  the  heart  ?  how  it  palpitates  or  remits  in 
its  beats !  it  may  even  stand  still  for  ever ;  and  more  than  once  in  my  life 
have  I  known  it  to  do  this  during  the  ague-fit.  But  the  joints  may  be  the 
weak  points  of  the  patient's  body  ? — then,  as  a  matter  of  course,  the  joints 
swell,  and  become  more  or  less  hot  and  painful.  And  if  just  at  this 
epoch,  some  wiseacre  of  the  profession  chances  to  drop  in — with  the  usual 
scholastic  sagacity,  he  discovers  the  disease  is  not  fever,  but  Rheum 
The  lancet,  of  course,  is  immediately  bared — the  leech  and  the  blister  are 
ordered;  from  this  moment,  the  entire  treatment  is  directed,  not  to  the  be- 
ginning, but  to  the  end — not  to  the  fever,  but  to  its  development.  The  state 
of  the  joints  is  the  sole  subject  of  thought  and  action  ;  the  Brain — that  Pan- 
dora's box  of  the  whole — that  organ  upon  which  every  motion  of  the  body, 
wrong  or  right,  depends  —  never  once  enters  into  the  wonderfully  wise 
man's  head;  he  never  once  dreams  of  influencing  this  key  to  all  the  corporeal 
actions,  in  any  manner  whatever.  And  what  is  the  result  of  this  treatment  ? 
Daily  promises  and  daily  disappointments;  hope  deferred  and  the  heart 
made  sick  ;  the  health,  the  happiness,  and  the  home  of  the  patient,  too  often 
made  desolate  for  ever. 

Thus  far,  gentlemen,  I  have  detailed  to  yon  the  beginning,  the    pro 


LECTURE  II.  41 

and  some  of  the  more  important  terminations  of  what  is  usually  called  a  per- 
fect ague-fit.  I  must  now  tell  you  that  all  agues  are  not  equally  perfect; 
the  stages  of  the  fit  in  particular  cases  may  vary  in  duration ;  the  bolder 
features  or  symptoms  may  be  all  more  or  less  subdued  ;  the  intermission,  or 
immunity  from  suffering,  instead  of  extending  to  a  day  or  days,  may  be  only 
an  hour  or  two  in  duration.  The  disease  is  now  no  longer  Intermittent 
Fever  or  Ague  ;  physicians  change  its  name  to  Remittent  Fever.  Remittent 
Fever  may  be  either  the  primary  disease  ;  or  the  fever  may,  in  the  com- 
mencement, be  a  veritable  ague  ;  recurring  and  re-recurring,  in  the  first 
instance,  at  perfectly  periodic  intervals  of  a  day  or  more  ;  yet  slide  by  de- 
grees into  a  fever  of.  the  remittent  form.  And  this  Remittent  Fever  again, 
whether  it  be  the  original  or  secondary  disease,  from  its  periods  of  access 
or  interval  becoming  still  less  obviously  marked,  may  assume  the  shape  and 
shade  of  disease  incorrectly  termed  "  Continued  "  Fever ;  which  last,  from 
long  duration  and  other  circumstances,  may  terminate  in  that  most  terrible 
state  of  mental  and  corporeal  prostration,  by  the  schools  denominated  Ty- 
phus Fever  ;  from  a  Greek  word  signifying  stupor  or  unconsciousness,  that 
being  one  of  the  most  common  symptoms. 

What,  then,  are  all  these  fevers  but  varieties  or  shades  of  each  other  ? 
What  can  a  sick  man  be  but  the  alteration  of  a  healthy  man  ;  his  tem- 
perature altered,  his  movements  altered  ?  the  periodicity  of  most  of  his 
functions  altered,  the  material  of  his  body  in  both  states  must  be  the  same! 
During  the  course  of  all  or  any  of  the  fevers  we  have  mentioned,  every  or- 
ganic affection,  every  possible  local  change  you  can  name  or  imagine,  may, 
with  more  or  less  quickness,  be  developed  ;  giving  occasion,  of  course,  to  the 
attending  practitioner  to  baptize  the  disease  anew  :  and  this  he  may  either 
do,  according  to  the  locality  of  such  organic  change,  or  according  to  the  loca- 
tity  in  which  particular  sj^mptoms  may  induce  him  to  suspect  its  existence. 
Should  a  new  doctor  chance,  just  at  this  time,  to  be  asked  to  see  the  patient, 
what  a  fine  opportunity  for  a  very  pretty  quarrel !  And  the  practitioner 
who  attended  from  the  beginning,  though  he  may  have  practised  the  right, 
shall  very  likely  be  dismissed,  while  the  other  for  advising  the  wrong  may 
as  certainly  be  detained,  and  be  esteemed,  at  the  same  time,  as  an  angel, 
or  an  oracle  at  least.  You  are  doubtless  curious  to  know  the  "  wherefore''''  of 
this.  But  there  is  nothing  so  very  curious  in  the  matter  after  all.  For  if 
you  only  reflect  how  few  people  in  the  world  can  get  further  than  the  sur- 
face of  things  ;  how  few  can  see  beyond  present  signs  and  present  symptoms, 
you  will  not  be  astonished  that  the  new  doctor,  who  shall  place  his  finger 
on  the  organ  for  the  time  most  implicated,  and  wrongly  set  that  down,  not  as 
the  End  but  as  the  Beginning,  not  as  the  consequence  or  effect,  but  as  the 
origin  and  cause  of  the  totality  of  disturbance,  will  be  preferred  to  him  whose 
experience  of  the  whole  case  led  him  rightly  to  look  upon  the  local  disease 
as  the  gradual  development  of  repeated  febrile  attacks.  But  the  new  prac- 
titioner will  not  always  be  content  merely  to  seize  upon  the  local  termination 
as  the  cause  or  beginning  of  the  mischief,  and  proceed  to  treat  it  accordingly ; 
he  will  very  often  drop  a  hint,  at  the  same  time,  that  but  for  neglect  of  this 
the  case  might  have  taken  a  more  favourable  turn.  Suppose,  for  example, 
Pulmonary  Consumption  to  be  the  after  result  of  the  original  fever.  "  What 
a  pity,"  the  learned  man  will  say,  "  I  was  not  called  in  at  first,  for  then  I 
should  have  at  once  attacked  the  seat  of  the  disease — the  chest."  Then, 
Gentlemen,  when  no  consumptive  symptom  existed ;  then,  when  the  weak  point 
of  the  patient,  for  all  you  know,  I,  or  any  other  doctor  knew,  or  could  know, 
might  have  been  the  liver,  stomach,  or  anything  else  !  And  by  that  pretty 
speech  of  his,  nine  times  out  often,  such  new  doctor  will  succeed  in  securing 
the  esteem  of  the  persons  who  employ  him.  Now  this  is  a  hard  case  for 
the  honest  and  more  able  practitioner;  but  so  the  workVwags. 

Until  the  publication  of  my  work,  the  Fallacy  of  Physic  as  taught  in  the 
Schools,  it  was  the  almost  "universal  belief  of  medical  professors  that  ague 


42  LECTURE  II. 

could  only  be  caused  by  emanations  from  the  fens ;  the  complaint  being  very 
common  in  fenny  countries ;  indeed  I  am  not  sure  that  this  belief  is  not  even 
now  one  of  the  numerous  absurdities  still  taught  in  our  schools  and  univer- 
sities. But,  Gentlemen,  there  is  no  agent  in  nature  which  may  not  cause 
ague,  from  a  blow  to  a  passion.  Lord  Byron's  mother,  according  to  Mr. 
Moore,  died  from  a  "fit  of  ague  brought  on  by  rage  or  vexation,  caused  by 
reading  her  upholsterer's  bill."  The  close  analogy  subsisting  between  ague 
and  the  passions,  has  not  escaped  the  observation  of  the  poets.  Shakspeare, 
ae  1  shall  afterwards  show  you,  often  alludes  to  it ;  and  Coleridge,  if  I  mis- 
take not,  says, 

"  There's  no  philosopher  but  sees 

That  Rage  and  Fear  are  one  disease, 

Though  this  may  burn  and  that  may  freeze, 
They're  both  alike  the  Ague." 

You  see,  then,  there  can  be  no  corporeal  agitation,  no  constitutional  revolu- 
tion, without  a  change  of  temperature  of  some  kind.  Butler,  in  his  Hudi- 
bras,  tells  us, 

"  Love's  but  an  ague  fit  reversed, 
The  hot  fit  takes  the  patient  first."      * 

Seriously,  you  will  do  well  to  ponder  on  the  relations  which  the  effects  of  the 
various  passions  bear  to  ague.  Throughout  them  all  you  may  observe  the 
same  tremor  and  thermal  changes ;  and  in  many  cases  the  diseases  which 
they  may  cause  become  equally  periodic  and  recurrent.  A  young  lady  was 
to  have  been  married  on  a  particular  day ;  but  on  the  very  morning  of  that 
day  the  bridegroom  was  accidentally  killed.  The  grief  of  the  lady  ended  in 
insanity.  The  fit  in  this  case  came  on  every  day  at  the  same  time ;  but 
during  the  remainder  of  the  twenty -four  hours,  she  had,  in  scholastic  phrase, 
a  "lucid  interval;"  in  other  words,  an  intermission  amounting  to  sanity. 

What  are  the  constitutional  effects  of  a  fall  or  a  severe  blow  ?  Do  we  not 
perceive  the  same  tremor  in  the  first  instance — the  same  pallor  and  loss  of 
strength  so  remarkable  in  the  cold  stage  of  ague  ?  Have  we  not  the  same 
hot  or  febrile  fit  succeeding  ?  "  The  fevers,"  says  Mr.  Abernethy,  "  pro- 
duced by  local  disease  [local  injury?]  are  the  very  identical  fevers  which 
physicians  meet  with  when  there  is  no  external  injury."  How  can  they 
be  otherwise,  since  it  is  only  by  the  matter  of  the  body  changing  its 
motive  relations  and  consequent  thermal  conditions  in  an  identical  manner 
in  both  cases,  that  we  obtain  the  group  of  symptoms  included  by  phy- 
sicians under  the  abstract  word  "Fkver?"  The  agents  which  cure 
fever  from  a  blow,  are  the  same  agents  which  cure  fever  from  a  passion, 
a  poison,  or  a  viewless  and  unknown  cause.  When  a  man  is  hot,  and  his 
skin  dry  all  over,  no  matter  what  the  cause  be,  you  may  bring  his  condition 
to  the  state  of  health  by  throwing  cold  water  over  him.  You  may  do  the 
same  by  an  emetic.  Oh  !  an  emetic  has  a  wonderful  power  in  Fever  ;  and 
the  old  physicians  treated  all  fevers  in  the  first  instance  by  emetics.  They 
did  not  trouble  themselves  much  about  the  cause.  The  state  of  the  patient 
was  what  they  cared  most  about.  When  he  was  cold,  they  warmed  him, 
sometimes  with  one  thing,  sometimes  with  another.  When  hot,  they  cooled 
him;  not  in  the  Sangrado  fashion  of  these  days,  by  draining  nim  of  hi 
blood  ;  but  by  the  employment  of  an  emetic,  or  by  sponging  him  over  with 
cold  water  !  By  bleeding  a  man  in  the  hot  stage  of  fever,  you  may  cool  him 
certainly  ;  but  unless  you  cool  him  to  death,  you  cannot  thereby  keep  the  lit 
from  returning.  When  it  does  return,  you  may  bleed  him  again,  it  is  true  ; 
but  how  often  may  you  do  this  safely  ?  So  far  as  my  experience  of  medical 
matters  goes,  few  people  in  these  times  arc  permitted  to  die  of  disease.  The 
orthodox  fashion  is  to  die  of  the  doctor  !  Gentlemen,  we  daily  henr  of  the 
terms  "  Constant"  and  "Continued''  lever;  but  there  never  was,  nor  can 
there  be,. a  fever  without  a  remission  or  period  of  comparative  immunity  from 
suffering,  more  or  less  marked.     Most  writers  of  name,  from  C alien  "down- 


LECTURE  II.  43 

wards,  admit  this ;  but  what  does  it  signify  whether  they  admit  it  or  not  ? 
use  your  own  eyes,  and  you  will  find  it  to  be  the  truth.  You  have  only, 
then,  to  prolong  that  period  of  immunity  to  an  indefinite  time,  and  whatever 
be  the  name  of  the  disease,  you  have  health.  By  Bark,  Opium,  and  the  va- 
rious chrono-thermal  medicines,  you  may  in  most  cases  succeed.  But  in- 
stead of  trying  to  prevent  recurrence,  practitioners  now-a-days  only  tempo- 
rise during  the  fit ;  and  this  is  the  most  profitable  practice  ;  for  a  long  siok- 
ness  makes  many  fees  !  The  honest  physician  will  do  his  best  to  keep  the 
fit  from  returning.  Now  if  blood-letting  were  certain  to  do  that,  how  could 
we  possibly  hear  of  people  being  bied  more  than  once  for  fever  ?  Do  we  not 
hear  of  repeated  applications  of  the  lancet,  and  of  the  patient  dying  notwith- 
standing ?  When  I  come  to  speak  of  Inflammation,  you  shall  see  how  little 
that  instrument  is  to  be  relied  on  in  fever,  or  rather  you  shall  find  that  its 
employment  at  all,  is  one  of  the  greatest  and  most  terribly  fatal  of  medical 
mistakes  !  How,  then,  is  it,  that  this  practice  has  so  long  maintained  its 
ground  ?  By  the  same  influence  that  for  thirty  centuries  determined  the  In- 
dian widow  to  perish  on  the  funeral  pile  of  her  husband — the  influence  of 
authority  and  custom  simply  !  In  physic,  Gentlemen,  as  in  other  things, 
men  are  "  bred  to  think  as  well  as  speak  by  rote  ;  they  furnish  their  minds  as 
they  furnish  their  houses,  or  clothe  their  bodies,  with  the  fancies  of  other 
men,  and  according  to  the  age  and  country.  They  pick  up  their  ideas  and 
notions  in  common  conversation  or  in  their  schools.  The  first  are  always 
superficial,  and  both  are  commonly  false." — [Bolingbroke.]  The  first  step 
that  I  myself  made  in  rational  medicine,  was  to  unlearn  all  I  had  been 
taught :  and  that  at  the  beginning  was  difficult.  How  I  ever  came  to  be- 
lieve one-half  the  rubbish  propounded  by  medical  teachers,  I  cannot  now  un- 
derstand ;  for  the  whole  doctrines  of  the  schools  are  a  tissue  of  the  most 
glaring  and  self-evident  absurdities.  At  a  future  period  of  this  course  I  shall 
prove  my  assertion  ;  but  before  you  can  detect  error,  you  must  first  know 
truth,  and  this  it  shall  be  my  endeavour  to  point  out  to  you.  To  return,  then, 
to  Fever.  From  the  facts  and  observations  already  stated,  you  at  once  per- 
ceive that  during  each  paroxysmal  stages  of  an  ague,  the  entire  economy  is 
more  or  less  altered  and  revolutionised.  It  matters  very  little,  upon  what 
part  of  the  body  the  exciting  cause  or  causes  of  this  corporeal  disturbance 
shall  first  fall ;  whether  directly  upon  the  brain  in  the  shape  of  a  Passion,  a 
poison,  or  a  blow  on  the  head  ;  or  more  remotely,  as  in  the  case  of  a  sudden 
chill  of  the  whole  body,  or  the  mechanical  injury  of  a  joint,  or  other  external 
part — to  the  consequent  derangement  of  the  Brain  and  Nervous  System,  we 
still  refer  the  paroxysmal  symptoms.  Why,  after  these  symptoms  have 
once  completely  passed  away,  and  the  economy  has  been  comparatively  re- 
stored to  its  usual  healthy  motive  condition,  periodical  repetitions  of  the  dis- 
eased motions  should  yet  recur,  is  a  thing  not  more  inexplicable  than  that  the 
various  habits  of  Health  should, — in  certain  instances  with  our  conscious- 
ness, in  certain  other  instances  without  it, — all  have  a  tendency  periodically 
to  repeat  themselves.  Life  after  all,  both  in  Health  and  Disease,  is  a  series 
of  periodic  repetitions,  whether  we  regard  it  in  the  minor  movements  of  the 
organs,  or  in  the  greater  alternations,  remarkable  in  the  Unity  of  the  Body. 
To  most  of  us,  the  day  of  to-day  is  but  a  repetition  of  the  day  of  yesterday  ; 
modified,  it  may  be,  by  a  little  more  repose  or  a  little  more  stir  ;  hope,  fear, 
joy.  and  sorrow,  alternating.  Upon  this  subject  I  will  touch  more  at  large 
at  an  after  period  of  the  course.  Meantime,  as  the  symptoms  of  an  uncom- 
plicated Ague-tit  stand  out  boldly  in  relief;  and  as  in  every  other  form  of 
disease,  however  named,  or  by  whatever  caused,  these  symptoms  or  shades 
of  them  may  readily  be  traced,  I  take  Ague  for  the  type  of  the  whole.  But 
while  with  this  explanation  I  assume  every  disease  to  be  in  the  first  instance 
an  ague — do  not  suppose  for  a  moment  that  I  employ  the  term  in  any  con- 
fined" sense.  Call  the^  symptoms  ague,  fever,  or  what  you  please,  consti- 
tutional disturbance  is  the  prelude  to  every  disease — the  precursor  of 


44  LECTURE  II. 

every  kind  of  local  mischief  not  immediately  produced  by  chemical  or  me- 
chanical agency.  In  numerous  cases,  if  not  in  all — more  especially  after  re- 
peated paroxysmal  recurrence,  superadded  local  phenomena  appear,  and  these 
last,  in  some  instances,  may  be  of  a  kind  so  grave  and  important,  as  to  throw 
the  constitutional  symptoms  for  a  time  altogether  into  shade.  Some  -part  of 
the  system,  in  a  word,  may  be  so  much  more  prominently  implicated  than 
another,  as  to  become  the  chief  feature  of  the  case — functionally,  if  the 
atomic  movements  only  be  altered — organically,  if  the  part  in  question  be 
threatened  with  a  change  in  its  structure  tending  in  any  way  to  its  destruc- 
tion or  decay.  Of  the  first,  you  have  an  example  in  the  spasm  or  palsy  of  a 
muscle,  or  the  suspension  or  too  great  flow  of  a  secretion.  Of  the  second,  I 
can  give  you  no  better  instances  than  that  disorganising  disease  of  the  knee- 
joint,  termed  "white-swelling,"  and  that  too  common  termination  of  chest 
disease  in  this  country — Phthisis,  as  it  is  termed  by  medical  men — Consump- 
tion or  Decline  by  the  vulgar. 

The  propriety  of  adopting  any  remedial  measure  has,  in  every  case,  more 
or  less  relation  to  Time  and  Temperature.  But  the  beneficial  influence  of 
the  Peruvian  Bark,  and  its  preparation  Quinine,  would  appear,  more  than 
any  other  agent,  to  depend  upon  the  period  in  which  we  administer  it.  The 
proper  period  for  its  exhibition  is  during  the  remission.  With  the  exception 
of  Opium,  it  is  more  strictly  a  preventive  than  any  other  known  agent.  So 
generally,  indeed,  has  it  been  found  to  answer  this  purpose  in  the  treatment 
of  Ague,  that  many  teachers  of  medicine  have  vaunted  it  as  a  Specific  for 
this  distemper;  but,  as  we  stated  to  you  in  our  former  lecture,  there  is 
no  such  thing  as  a  specific  in  nature  for  any  disease  whatever.  For,  did 
there  exist  a  specific — did  there  exist  a  remedy  that  could  certainly  cure  all 
cases  of  a  given  disease,  man,  so  far  as  that  disease  is  concerned,  would  be 
immortal !  Had  there  been  a  specific  for  ague,  do  you  think  the  court  doc- 
tors would  have  permitted  Oliver  Cromwell  to  die  of  it  ?  Whatever  be  the 
agency  by  which  this  or  any  other  disease  has  been  cured,  you  shall  find, 
in  the  course  of  these  lectures,  ample  evidence  that  its  influence 
relates   in    every    case   to    Change   of   Temperature.     Major-General  Sir 

R A ,  while  serving  in  Portugal,  became  the  subject  of  severe  ague, 

which  resisted  a  host  of  remedies  prescribed  for  him  by  numerous  medical 
friends  ;  Bark  among  the  number.  One  day,  when  riding  out,  he  was  seized 
with  a  paroxysm.  The  inmate  of  a  little  shop,  where  he  dismounted  till  the 
fit  should  be  over,  suggested  to  him  to  try  the  barber-surgeon  of  his  neigh- 
bourhood. Willing  to  be  cured  by  any  body,  or  by  anything,  Sir  R.  at  once 
agreed.  The  ambidexter  man  of  medicine  came,  ordered  him  a  large  plaster 
to  his  back,  and  the  ague  was  forthwith  cured  !  Gentlemen,  to  what,  but  to 
the  improvement  of  the  Temperature  of  the  spine,  must  we  attribute  the  suc- 
cess of  that  plaster  ?  The  general  good  effect  of  Quinine  in  keeping  off  the 
ague-fit,  when  it  proceeds  from  viewless  causes,  is  sufficiently  well  known 
to  every  member  of  the  profession  ;  but  it  is  not  so  generally  understood  that 
the  same  agent  may  be  equally  serviceable  in  cases  produced  by  looal  injury. 
Of  this,  however,  I  will  give  you  a  proof.  A  gentleman,  shortly  alter  hav- 
ing had  a  bougie  passed,  was  seized  with  ague  of  the  most  perfect  kind  ;  two 
days  after,  at  the  same  hour,  he  had  a  return,  and  every  alternate  day  it  re- 
curred, till  he  had  experienced  about  twelve  paroxysms;  then,  for  the  first 
time,  he  took  quinine,  and  he  had  no  repetition.  He  never  had  ague  before 
that  occasion,  nor  at  any  time  afterwards,  unless  when  compelled  to  use  the 
bougie. 

1  do  not  know  that  I  can  better  commence  my  proof  of  the  intermittent 
nature  of  disease  generally,  than  by  entering  into  a  short  consideration  of 
what  are  termed 

Spasmodic  Complaints. 

Such  complaints  being  unattended  with  any  structural  change,  are  termed 
by  the  profession  kim.tio.nal;  a  word,  as  we  have  seen,  expressive  of  their 


LECTURE  II.  45 

simplicity.  What  is  the  meaning  of  the  term  Spasm  ?  It  means  an  irre- 
gular or  unnatural  contraction  of  some  muscle  of  the  body  ;  and  in  the  case 
of  the  voluntary  muscles,  you  cannot  by  any  effort  of  the  will  control  or 
counteract  it.  By  rubbing  and  warming  the  part,  you  may  sometimes  suc- 
ceed, and  there  are  a  great  many  medicines  by  which,  when  taken  internally, 
the  same  effect  may  be  produced  ;  but  what  will  answer  in  one  case  may  not 
answer  in  another.  The  disease  is  sometimes  termed  Convulsion,  and  Cramp 
also  ;  more  especially  if  the  spasms  be  painful.  The  difference  of  locality 
in  which  spasms  take  place  in  different  persons  has  afforded  professors  an 
excellent  opportunity  of  mystifying  the  whole  subject.  When  it  happens  in 
the  membraneous  lining  of  the  lachrymal  duct,  the  tears  accumulate  at  the 
inner  angle  of  the  eye,  from  the  passage  to  the  nose  being  closed  up  by  the 
contracting  spasm.  This  disease  is  called  Epiphora,  and  sometimes, 
though  not  quite  correctly,  Fistula  Lachrymalis.  Sneeze,  Hiccough,  and 
Yawn,  are  also  effects  of  spasmodic  action.  Occurring  in  the  muscular  appa- 
ratus of  the  windpipe,  or  its  divisions,  spasm  is  familiar  to  you  all  in  the  v/ord 
Asthma  ;  and  it  is  also  termed  Dyspnoza,  from  the  difficult  breathing  which 
it  certainly  occasions.  When  this  spasmodic  action  affects  the  muscles 
about  the  jaws  and  throat,  and  the  patient  at  the  same  time  has  convul- 
sions of  the  face  and  limbs,  there  is  usually  loss  of  consciousness,  with  a  sud- 
den loss  of  power  in  all  his  members,  which  causes  him  to  fall.  This  is  the 
Epilepsy,  or  "  falling  sickness."  The  subject  of  the  disease  termed  Jaun- 
dice, in  ninety-nine  cases  out  of  a  hundred,  owes  the  yellow  colour  of  his 
skin  to  spasm — spasm  of  the  gall-ducts — though  any  other  obstruction  of 
these  passages — a  gall-stone  for  example,  may  give  rise  to  the  same  effect. 
Taking  place  in  the  ilium  or  small  intestines,  spasm  is  termed  the  Iliac  Pas- 
sion ;  in  the  colon  or  great  intestine,  Colic  ;  in  the  urethra,  Spasmodic  Stric- 
ture. The  Lockjaw  affords  yet  another  example  of  spasm.  That  all  these 
various  diseases  are  merely  effects  of  the  same  action  in  different  parts,  is 
proved  by  each  and  all  of  them  having  been  known  to  assume  the  most  per- 
fectly periodic  type  in  individual  cases,  and  by  all  being  more  or  less  ame- 
nable to  the  same  class  of  remedies  most  generally  influential  in  keeping  off 
the  ague-fit. 

Like  every  other  Force  in  nature,  our  remedial  powers  all  act  by  causing 
Attraction  or  Repulsion ;  and  for  a  reason  to  be  afterwards  given,  every 
remedy  can  act  both  ways  in  different  individuals.  All  medicinal  agencies 
have  the  power  of  producing  inverse  motion ;  and,  in  this  way,  they  cure  or 
alleviate  in  one  case,  while  in  another  they  cause  or  aggravate  disease.  Opium, 
for  example,  will  set  one  man  to  sleep,  and  keep  another  wakeful.  Arsenic 
has  cured  the  tremor,  chill,  and  heat  of  ague,  and  produced  them  in  a  previ- 
ously healthy  person.  The  same  results  have  followed  the  exhibition  of 
opium,  bark,  and  copper.  Moreover,  to  all  four  have  I  traced  diseases  with 
fits  and  remissions.  A  girl  took  a  large  dose  of  arsenic  (sixty-four  grains) 
for  the  purpose  of  suicide  ;  her  design  was  discovered  in  sufficient  time  to 
prevent  her  death ;  but  a  periodic  epilepsy  ushered  in  by  chills  and  heats 
was  the  result.  A  man  of  the  30th  Foot,  after  a  course  of  hard  drinking, 
became  epileptic  :  his  disease  came  on  every  second  day  at  the  same  hour. 
Quinine,  silver,  and  calomel,  were  tried  without  success.  I  then  gave 
him  arsenic,  after  which  he  never  had  another  fit.  In  these  two  cases, 
then,  arsenic  produced  inverse  motions,  causing  epilepsy  in  the  first, 
and  curing  it  in  the  second.  When  I  come  to  treat  particularly  of  the  pas- 
sions, I  shall  show  you  that  the  same  passion  which  has  caused  an  ague  or 
an  epilepsy,  may  cure  either.  In  truth,  I  scarcely  know  a  disease  which  the 
passions,  Rage  and  Fear,  have  not  cured  and  caused,  according  to  their  at- 
tractive or  repulsive  mode  of  action  in  particular  cases. 

I  have  said  that  Asthma  is  an  intermittent  disease.  "  The  fits  of  convul- 
sive asthma,"  according  to  Darwin,  "  return  at  -periods,  and  so  far  resemble 
the  excess  of  an  intermittent  fever."  Had  this  physician's  knowledge  of  the 
nature  of  asthma  been  sufficiently  complete,  he  would  have  told  us  that  be- 


46  LECTURE  II. 

tween  ague  and  asthma  there  is  something  more  than  a  resemblance  ;  that  the 
asthmatic  patient,  in  fact,  has  an  ague,  with  the  further  development  of  spawn 
of  some  of  the  muscles  of  the  windpipe.  But  call  the  disease  what  you  please, 
I  have  generally  cured  it  with  one  or  other  of  the  chrono-thermal  remedies ; 
and  with  two  or  more  in  combination,  I  can  most  truly  say  I  have  seldom 
been  compelled  to  complain  oflll-success  in  its  treatment.  In  one  case,  how- 
ever,— that  of  a  gentleman  who  had  the  disease  every  second  night, — I  had 
the  greatest  difficulty  in  effecting  a  cure,  for  it  was  not  till  I  had  nearly  ex- 
hausted all  my  best  resources,  that  I  at  last  obtained  success  by  applying  a 
warm  plaster  all  along  his  spine.  Here  you  again  see,  in  the  most  direct 
manner,  the  advantage  of  attention  to  temperature  :  the  spine,  in  this  case, 
was  always  chilly,  but  became  warm  and  comfortable  under  the  use  of  the 
plaster.  The  analogy  which  subsists  betwixt  Spasm  and  Tremor,  has  not 
been  unnoticed  by  medical  writers.  Analyze  "  tremor,"  "  shivering,"  "  .-hik- 
ing," and  you  will  find  the  motions  so  termed  to  be  merely  a  rapid  succession 
of  incomplete  spasm.  In  St.  Vitus' s.dance,  or  as  it  is  sometimes  called,  "the 
leaping  Ague,"  which  is  also  a  periodic  disease,  you  may  see  every  variety  of 
Spasmodic  and  tremulous  action  a  muscle  can  exhibit.  It  is  a  frequent  disease 
of  children,  and  in  most  cases  you  may  obtain  success  with  minute  doses  of  one 
or  more  of  the  chrono-thermal  remedies ;  one  remedy  of  course  answering 
better  in  onecase,  another  in  another. 

"With  the  same  agents,  prescribed  upon  the  same  principle,  I  have  been 
equally  fortunate  in  the  treatment  of  Urethral  Stricture — a  disease  for  which 
the  bougie,  in  general  practice,  is  far  too  indiscriminately  employed.  You 
all  know  the  beneficial  influence  of  the  warm  bath  in  this  affection,  and  some 
of  you  may  have  heard  of  the  same  good  result  from  the  internal  use  of  Iron. 
But  the  influence  of  Quinine  over  stricture  is  not  so  generally  known.  It  is 
unnecessary  for  me  to  give  any  instance  of  my  own  in  evidence  of  this,  Sir 
Benjamin  Brodie  having  published  at  length  the  case  of  a  gentleman  afflicted 
with  spasmodic  stricture  of  the  tertian  type — that  is  to  say,  a  stricture  which 
came  on  every  alternate  night  about  the  same  hour, — and  which  yielded,  in 
the  hands  of  that  surgeon,  to  quinine.  The  marked  periodicity  of  this  case, 
doubtless,  suggested  the  proper  treatment ;  but  in  cases  where  this  is  less 
striking,  you  have  only  to  ask  the  patient,  if  there  are  times  when  he  passes 
his  water  better  than  others  ;  and  if  he  answers  in  the  affirmative,  you  may 
be  sure  the  stricture  depends  less  on  a  permanent  thickening  of  the  mucous 
membrane  of  the  urethra,  than  upon  a  remittent  spasmodic  action  of  its  mus- 
cular apparatus.  Such  a  patient,  on  coming  out  of  a  warm  room  into  a  cold 
one,  will  find  himself,  all  in  a  moment,  unable  to  pass  a  drop  of  water. — 
See  then  the  effect  of  thermal  change — of  change  of  temiicrature — in  producing 
spasm  ;  and  hence,  too,  the  benefit  to  be  derived  from  the  warm  bath  in  the 
treatment  of  spasm  generally.  In  the  great  majority  of  strictures,  the  surgeon 
may  save  himself  the  trouble,  and  his  patient  the  torture,  of  passing  the  bougie 
at  all,  by  treating  the  disease  chrono-thermally  ;  that  is,  if  he  prefers  the  in- 
terest oi  the  public  to  his  own  ;  but  this  mode  of  preventing  the  return  of  the 
disease  is  obviously  less  lucrative  than  that  which  enables  him  to  give  tern, 
porary  relief  at  the  expense  of  a  long  attendance. 

We  now  come  to  that  particular  form  of  disease  termed 
I 

Palsv  or  Paralysis  : 

an  affection  in  which,  when  complete,  there  is  an  absolute  loss  of  muscular 
power.  From  the  suddenness  with  which  the  patient  is,  in  most  ins) 
affected  or  "struck,"  this  disease  is  known  to  every  body  under  the  name  of 
••  Paralytic  Stroke  ;"  or,  more  familiarly  still,  "  a  stroke."  It  consists  either 
in  a  partiul  or  complete  inability  to  use  the  iffected  muscles — for  there  are 
degrees  of  palsy  as  of  every  other  disease — an  inability  to  excite  their  action 
in  any  manner  whatever  by  the  will.     Now  it  is  a  common  error  of  the  schools 


LECTURE  II.  47 

to  teach  that  such  disorder  is  alivays  dependent  on  some  pressure  on  the 
brain  or  spine.  There  is  no  doubt  that  pressure  on  these  parts  can  cause 
palsy  ;  but  much  more  frequently  this  disease  is  the  effect  of  a  weakness  of 
the  brain  or  spine,  produced  by  exhaustion,  the  cause  of  such  exhaustion  be- 
ing various  of  course.  Paralytic  disease  has  often  been  produced  by  a  purge, 
and  oftener  still  by  loss  of  blood.  The  recent  case  of  Sir  William  Geary 
must  be  still  fresh  in  every  body's  mind.  That  gentleman  met  with  a  sud- 
den loss  of  blood  from  an  accidental  wound  of  the  carotid  artery  ;  palsy  of 
the  left  side  ensued.  Weakly  persons,  on  suddenly  rising  from  their  chair, 
sometimes  all  at  once  lose  the  use  of  a  leg  or  arm.  Most  cases  of  paralytic 
disease,  if  properly  sifted,  will  be  found  to  be  only  the  termination  of  pre- 
vious constitutional  disturbance  ;  previous  threatenings  of  such  loss  of  power 
having  been  more  or  less  frequently  felt  by  the  subjects  of  every  case.  More- 
over, in  a  number  of  cases,  palsy  is  an  intermittent  disease  throughout  its 
whole  course,  being  preceded  by  chills  and  heats,  and  going  off  with  a  return 
of  the  proper  temperature  of  the  body.  How  can  you  reconcile  the  idea  of 
permanent  pressure  with  intermittent  phenomena  1 

In  one  of  the  numbers  of  the  Dublin  Journal,  I  find  a  case  of  paralysis  of 
some  of  the  muscles  necessary  for  the  proper  performance  of  the  functions  of 
speech — Aphonia,  as  it  is  called  by  professional  men.  This  case  will  show 
you  that  palsy,  like  every  other  form  of  disorder,  may  exhibit  the  most  per- 
fect periodic  intermissions.  It  is  taken  from  a  foreign  journal  [Hecker's]. 
41  A  peasant  girl  was  attacked  in  the  following  manner : — Speechlessness 
came  on  every  day  at  four  o'clock,  p.m.,  accompanied  by  a  feeling  of  weight 
about  the  tongue,  which  remained  a  quarter  of  an  hour.  The  patient,  while 
it  lasted,  could  not  utter  any  sound,  but  occasionally  made  an  indistinct  hiss- 
ing noise.  ,  Consciousness  did  not  seem  impaired  during  the  fit.  She  ascribed 
her  inability  to  speak  to  a  feeling  of  weight  in  the  tongue.  The  paroxysms 
went  off  with  a  large  evacuation  of  watery  urine,  accompanied  by  perspira- 
tion and  sleep.  Ten  such  attacks  had  occurred,  when  Dr.  Richter  of  Wies- 
baden was  called  to  see  her ;  he  ordered  her  considerable  doses  of  sulphate  of 
Quinine,  with  immediate  good  effect  from  the  first  day.  The  attack  returned, 
but  in  a  mitigated  form,  and  on  the  second  day  no  trace  of  it  was  visible, 
except  a  certain  degree  of  debility  and  fatigue,  felt  at  the  usual  hour  of  its  com- 
ing on."  The  corporeal  temperature  is  not  stated  by  the  reporter  of  the  case, 
but  the  periodic  manner  in  which  it  came  on  and  went  off,  to  say  nothing  of 
the  mode  of  its  cure,  sufficiently  illustrates  its  nature.  Not  long  ago,  I  was 
consulted  in  a  similar  case,  which  was  moreover  complicated  with  palsy  of 
one  side.  Sarah  Warner,  aged  25,  married,  had  suffered  periodically  from 
loss  of  speech,  and  also  an  inability  to  move  the  leg  and  arm  of  one  side. 
Various  remedies  had  been  ineffectually  prescribed  by  her  medical  attend- 
ants, who  all  looked  upon  her  disease  as  Apoplectic — in  other  words,  they 
supposed  it  to  be  caused  by  pressure  on  the  brain.  One  of  them,  indeed, 
proposed  to  bleed  her,  but  she  would  not  consent.  When  she  applied  to  me, 
I  ordered  her  a  combination  of  Quinine  and  Iron,  after  which  she  never  had 
another  fit. 

I  shall  now  give  you  the  details  of  a  case  of  palsy  which  I  treated  suc- 
cessfully, after  it  had  been  long  considered  hopeless :— Mrs.  Sargent,  aged 
40,  a  married  woman,  and  the  mother  of  several  children,  had  kept  her  bed 
for  eight  years,  on  account  of  paralysis  of  the  lower  extremities  ;  during  which 
period  she  had  been  under  the  treatment  of  eight  or  nine  different  physicians 
and  surgeons  of  the  Cheltenham  dispensary,  Dr.  Cannon  and  Mr.  C.  T. 
Cooke  among  others.  Such  at  least  was  the  woman's  own  statement,  con- 
firmed to  me  bv  many  people  of  respectability,  who  had  visited  her  from  the 
commencement  of  her  illness.  When  I  first  saw  her,  she  could  not  move 
either  leg;  her  voice  was  an  almost  inaudible  whisper;  she  was  liable  to 
frequent  retchings,  and  she  complained  of  spasms  with  much  pain  of  the  loins 
and  limbs.     Her  last  dispensary  medicine,  mercury,  which  she  believed  had 


48  LECTURE  II. 

been  given  her  by  mistake,  had  produced  salivation,  but  with  decided  aggra- 
vation of  her  symptoms.  In  this  case,  I  prescribed  a  combination  of  reme- 
dies, the  principal  of  which  were  hydrocyanic  acid  and  tincture  of  cantharides. 
Under  this  treatment,  her  voice  returned  in  about  a  week ;  her  recovery  from 
every  symptom  was  complete  in  6ix  weeks,  and  she  had  no  return  in  three 
years  after  she  was  under  my  care  :  nor,  so  far  as  I  know,  since  that  time. 

Charles  Overbury,  aged  10,  had  been  in  a  curious  state  for  six  months 
previous  to  my  first  visit.  I  found  him  lying  upon  a  couch,  every  muscle 
of  his  face  in  such  complete  repose,  that  his  countenance  seemed  quite  idiotic  ; 
his  arms  and  legs  were  perfectly  powerless,  and  if  you  held  him  up,  his  limbs 
doubled  under  him  like  those  of  a  drunken  person.  Upon  whichever  side  you 
placed  his  head,  he  was  unable  to  remove  it  to  the  other.  It  was  with  diffi- 
culty he  8 wallowed  his  food,  but  the  heart  and  respiratory  muscles  performed 
their  respective  offices  with  tolerable  correctness.  The  patient  laboured  under 
complete  loss  of  speech  the  entire  night,  and  nearly  the  whole  day.  About 
the  same  time  daily,  noon,  he  could  utter  his  monosyllables,  yes  and  no  ;  but 
this  power  remained  with  him  for  half-an-hour  only.  The  remedies  to  which 
I  resorted  in  this  case  were  minute  doses  of  calomel,  quinine,  and  hydrocy- 
anic acid,  all  of  which  improved  him,  but  the  last  proved  most  effectual.  In 
less  than  three  weeks,  he  was  running  about,  well  in  every  respect,  and  the 
change  in  his  countenance,  from  apparent  idiocy  to  intelligence,  was  as  perfect 
a  transformation  as  it  is  possible  to  imagine.  You  marked,  I  hope,  the  perio- 
dic, though  imperfect,  remissions  which  this  case  exhibited. 

The  case  of  the  celebrated  Madame  Malibran  may  still  be  fresh  in  some 
of  vour  minds.  It  was  completely  the  converse  of  this  boy's  disease,  for  at 
particular  times  the  muscles  of  that  actress  became  stiff  and  rigid  throughout 
the  entire  body.  When  taken  together,  these  cases  show  the  anajogy  which 
subsist  between  paralytic  and  spasmodic  affections ;  indeed,  in  many  cases, 
both  affections  co-exist  at  the  same  time  in  different  muscles  of  the  same 
person  ;  sometimes  they  are  complicated  with  idiocy  or  insanity. 

A  young  person  was  some  time  ago  brought  to  me  by  her  mother,  at  the 
request  of  the  Rev.  Edward  Murray,  brother  of  the  bishop  of  Rochester.— 
This  girl  had  not  only  complete  mental  imbecility,  or  paralysis  of  the  mental 
brain,  but  she  had  also  lost  the  use  of  one  side,  so  as  to  be  utterly  helpless  in 
every  way.  Every  night  also  when  she  was  put  to  bed,  she  had  an  epileptic 
attack.  In  this  case,  I  prescribed  a  combination  of  copper,  silver,  strychnia, 
and  quinine.  About  six  weeks  afterwards,  an  intelligent-looking  young  per- 
son walked  into  my  room  with  a  letter,  "from  the  Rev.  Edward  Murray." 
I  could  scarcely  believe  I  saw  before  me  the  same  girl ;  yet  she  was  speak- 
ing and  walking  as  well  as  she  ever  did  in  her  life.  Her  epileptic  fits  had 
become  faint,  few,  and  far  between,  and  she  was  then  the  monitor  of  her  class .' 
Now,  this  patient,  Mr.  Murray  informed  me,  had  been  ill  four  years,  and  had 
been  dismissed  the  Middlesex  "Hospital  "incurable." 

I  was  suddenly  called  to  see  Mrs.  T ,  of  Clarges  Street,  whom  I  found 

with  complete  loss  of  the  use  of  one  side,  and  partial  palsy  of  the  muscles  on 
the  same  side  of  the  fa-c.  She  had  been  nervous  and  ill  for  some  time,  and 
the  night  before  she  had  been  suffering  from  domestic  affliction.  The  next 
morning,  while  entering  her  own  door,  she  fell  as  if  she  had  been  shot.  When 
I  saw  her,  her  face  was  pallid,  and  her  feet  were  cold.  The  people  about 
her  were  urgent  that  she  should  be  bled,  but  I  ordered  her  warm  brandy  and 
water  instead.  A  gentleman,  who  was  formerly  her  medical  attendant,  was 
sent  for,  and  agreed  with  me  that  she  should  not  be  bled.  Under  the  use  of 
quinine  and  strychnia,  continued  for  about  six  weeks,  with  country  air,  she 
recovered  the  use  of  her  side  so  far  as  to  be  able  to  walk  without  a  stick  ; 
the  use  of  her  arm  also  returned.  Had  this  lady  been  bled  or  leeched,  she 
would  not  have  survived  many  days. 

I  will  now  give  you  a  case  or  two  exemplifying  the  cure  of  palsy  of  a 
single  limb. 


LECTURE  II.  49 

Case  1. — Mary  Bodily,  18  years  old,  from  the  age  of  eleven,  had  weak- 
ness of  the  back  and  loins,  and  she  gradually  lost  the  use  of  the  right  lea;.  In 
this  state  she  remained  for  three  years  ;  sixteen  months  of  this  period  she  was 
an  in-patient  of  the  Gloucester  Infirmary,  in  which  establishment  her  mother 
held  the  situation  of  nurse.  But  cupping,  bleeding,  leeching,  blistering, 
were  all  ineffectually  tried.  The  same  mode  of  treatment  as  in  Mrs.  Sar- 
gent's case,  with  the  addition  of  a  galbanum  plaster  to  the  loins,  in  which  she 
complained  of  coldness,  was  adopted  by  me,  and  followed  with  like,  success. 
She  had  scarcely  been  a  fortnight  under  my  care,  before  she  completely  re- 
covered the  use  of  her  paralytic  limb  ;  and  she  has  had  no  relapse  during  the 
last  four  or  five  years. 

Case  2. — Esther  Turner,  aged  30,  when  in  the  service  of  Mr.  Ward,  the 
master  of  a  respectable  boarding-school,  at  Painswick,  fell  down  stairs,  and 
from  that  moment  lost  the  use  of  her  leg.  After  a  period  of  eleven  years, 
during  which  she  had  been  ineffectually  under  treatment  in  various  hospitals 
and  infirmaries,  she  came  on  crutches  to  my  house.  She  explained  that  she 
was  subject  to  severe  shivering,  with  occasional  convulsions.  Her  leg,  she 
said,  hail  more  feeling  on  certain  days  than  others.  After  trying  her  for  some 
time  with  a  combination  of  hydrocyanic  acid  and  tincture  of  cantharides, 
without  any  improvement,  I  prescribed  a  pill,  containing  a  combination  of 
quinine,  silver,  and  colchicum,  night  and  morning.  She  progressed  from  that 
day  ;  and  in  about  six  weeks,  I  had  the  satisfaction  to  see  her  hi  possession 
of  the  complete  use  of  her  limb  ;  nay,  she  returned  to  her  service  at  Mr. 
Ward's,  which  she  only  left  to  get  married. 

Case  3. — Miss  M ,  aged  25,  had  lost  the  use  of  both  limbs  for  seven 

years ;  all  that  time  she  had  been  confined  to  her  bed,  and  though  she  had 
had  the  advice  of  several  professional  persons  of  eminence,  she  never  once 
could  stand  up  during  the  whole  of  that  period.  She  was  brought  up  to 
town  from  Yorkshire,  a  distance  of  260  miles,  on  a  sofa-bed,  to  be  placed 
under  my  care.  I  immediately  put  her  on  a  course  of  chrono-thermal  treat- 
ment, and  we  had  not  long  to  wait  for  improvement,  for  in  five  days  this 
young  lady  could  walk  round  the  table  with  the  partial  support  of  her  hands. 
At  the  end  of  two  months,  without  any  assistance  whatever,  without  even 
the  support  of  the  balusters,  she  could  run  up  and  down  stairs  nearly  as  well 
as  myself.  Should,  this  statement  be  considered  to  require  better  confirma- 
tion than  my  word,  I  am  permitted  to  give  Miss  M 's  name  and  address 

to  any  party  who  may  take  an  interest  in  the  case,  the  particulars  of  which 
she  will  readily  communicate.  Miss  M is  the  daughter  of  an  accom- 
plished English  clergyman,  and  is  the  nieee  of  one  of  the  judges  of  the 
supreme  court  of  Scotland,  who,  being  in  town  all  the  time  she  was  under 
mv  care,  saw  her  the  day  after  she  an'ived,  and  had  the  satisfaction  to  wit- 
ness the  whole  progress  of  her  cure. 

I  could  here  give  you  numerous  other  cases,  all  more  or  less  explanatory 
of  the  manner  in  which  Palsy  of  almost  every  muscle  of  the  body  may  be 
developed  and  cured.  For  the  present,  I  shall  content  myself  with  record- 
ing my  experience  of  a  disease,  which,  until  I  explained  its  nature,  was  never 
once  imagined  to  depend  on  Paralysis,  namely,  the  Curved  or  Crooked  Spine.* 
By  most  authors,  this  disorder  had  been  supposed  to  be,  under  all  circum- 
stances, an  affection  of  the  bones.  Some,  indeed,  vaguely  referred  it  to  pe- 
culiarity of  nervous  action ;  while  others  hypothetically  traced  it  to  loose- 
ness of  the  ligaments.  When  the  late  Mr.  Abernethy  said  it  was  owing  to 
a  "  rancour  in  the  muscles,"  he  only  used  an  unmeaning  phrase  to  conceal 
his  ignorance  of  the  entire  matter  ;  for  what  meaning  can  there  in  reality  be 

*  When  1  first  published  my  view  of  the  nature  of  Curved  Spine,  in  1836,  its  correctness  was  called 
in  question.  When  Stromeyer  and  others  on  the  continent,  without  noticiuj.'  my  labours,  afterwards 
adopted  my  explanation  as  their  own,  it  was  admitted  by  the  whole  profession  to  be  true.  What  a 
reward  to  the  real  cultivators  of  science,— first  to  have  their  discoveries  denied,  then  pilfered1 
The  reader  will  find  as  he  proceeds  that  this  is  not  the  only  instance  of  plagiarism  I  hare  to  com- 
plain of. 


50  LECTURE  II. 

in  the  word  "  rancour,"  when  applied  to  a  subject  like  this  ?  Rancour  is  an 
old  English  word  for  malignity  or- ill-temper  ;  but  how  can  that  apply  to  a 
state  of  perfect  muscular  repose, — to  a  palsy  ?  Nevertheless,  to  Mr.  Aber- 
nethy's  surgical  care,  almost  every  case  of  spinal  curvature,  among  the 
higher  ranks,  was  at  one  time  entrusted.  What  the  disease  really  is,  I  shall 
now  proceed  to  demonstrate. 

The  mast  of  a  ship  is  kept  erect  by  the  stays  and  shrouds :  if  you  divide 
or  loosen  these  on  one  side,  the  mast  falls  more  or  less  in  an  opposite  direc- 
tion. The  human  Spine  is  kept  upright  by  a  similar  apparatus — the  muscles. 
If  any  of  these  muscles  from  bad  health  become  weakened  or  paralysed  on 
any  side,  the  spine,  from  the  want  of  its  usual  supporting  power,  must  ne- 
cessarily, at  that  particular  place,  drop, to  the  other  side.  But  being  com- 
posed of  many  small  jointed  bones — the  vertebra — the  Spinal  column  cannot, 
like  the  mast,  preserve  its  upright  form,  but  when  unsupported,  must  double 
more  or  less  down  in  the  shape  of  a  curve  or  obtuse  angle  ;  and  the  degree 
and  situation  of  this  curvature  will  depend  upon  the  number  and  particular 
locality  of  muscles  so  weakened  or  paralysed.  This  disease  or  "  deformity," 
(for  Mr.  Abernethy  would  not  allow  it  to  be  anything  else,)  under  all  its  un- 
complicated variations  of  external,  internal,  and  lateral  curvature,  is  the  result 
of  muscular  weakness  or  palsy;  which  palsy,  for  the  most  part,  is  a  feature 
or  termination  of  long  remittent  febrile  disorder.  It  is  often  a  more  or  less 
rapid  developement  of  the  usual  diseases  of  children. — Scarlet  fever. 
Chicken-pox,  Measles,  and  so  forth  ;  all  of  which,  as  I  shall  afterwards  show 
you,  are  purely  remittent  fevers  ;  but  whether  complicated  with  vertebral 
disease  or  not,  Curved  Spine  is  no  more  to  be  influenced  by  issues. 
moxas,  &c,  except  in  so  far  as  these  horrible  measures  almost  invariably 
confirm  it  by  further  deteriorating  the  general  health  of  the  patient. 

In  the  commencement  of  most  cases  of  this  kind,  the  patient  is  taller  one 
day  than  another, — a  proof  that  the  curvature  then  very  much  depends  upon 
the  state  of  health  of  the  hour  ;  and  never  do  I  remember  to  have  had  such  a 
patient  who  did  not  confess  to  chills  and  heats,  or  vice  versa.  I  will  give  you 
two  cases  in  which  these  phenomena  were  observed. 

Case  1. — A  young  lady,  aged  16,  had  a  lateral  curvature  of  the  vertebrae 
of  the  upper  part  of  the  back,  (that  is,  a  curvature  to  one  side)  causing  the 
inferior  angle  of  the  shoulder-blade  to  protrude.  I  prescribed  tor  her  calo- 
mel and  quinine,  in  small  doses,  and  directed  her  to  have  her  spine  rubbed 
night  and  morning  with  soap  hniment.  In  less  than  a  month  the  patient  had 
gained  three  inches  in  height,  and  in  two  months  more,  she  was  erect. 

Case  2. — A  lady,  45  years  of  age,  the  mother  of  children,  had  her  spine  so 
much  curved  at  the  lower  part  of  the  loins,  that,  to  use  the  phrase,  her  "hip 
grew  out."  This  case  came  on  suddenly.  I  ordered  a  warm  plaster  to  be 
applied  to  the  spine,  and  prescribed  hydrocyanic  acid  and  quinine.  In  three 
weeks  she  stood  erect.  Four  years  afterwards  she  had  a  return,  when  the 
same  means  were  again  successfully  put  m  practice. 

These  two  cases,  Gentlemen,  were  cases  of  simple,  uncomplicated  palsy 
of  the  muscles  of  the  back.  There  are  yet  other  ways  in  which  curved 
spine  may  take  place — though  these  still  depend  on  a  loss  of  Health  of  the 
general  system.  The  mere  weight  of  the  body  will  in  some  eases  produce 
waste,  or,  professionally  to  speak,  "  interstitial  absorption"  of  particular  ver- 
tebrae or  of"  their  parts.  A  curve  of  course  must  follow  ;  but  Curvature  i  ; 
the  Spine  is  not  unfrequently  the  effect  of  .a  consumptive  disease  of  the  sub- 
stance of  the  vertebra? — a  process  by  which  one  or  mow  of  these  small  bones 
fall  into  a  state  of  ulcerative  decav.  Still,  even  in  these  oases  there  is  at  the 
same  time  a  greater  or  less  loss  of  power  in  particular  muscles— for  the  Baxue 
general  bad  health  that  weakens  the  bones  must  weaken  the  muscles  also. 
I  will  give  you  two  eases  illustrative  of  this  last  complication. 
Cast:  i.-  INlrs.  Craddock,  aged  25,  bad,  for  upwards  oi  eighteen  months, 
great  weakness  in  the  Upper  third  of  the  back,  where  u  swelling  made  its  ap- 


LECTURE  II.  51 

pearance,  gradually  increasing  in  size.  According  to  the  statement  of  this 
woman,  she  had  been  an  in-patient  of  the  Gloucester  Infirmary  for  seven 
months  ;  during  which  she  had  been  treated  by  issues  and  other  local  mea- 
sures, but  with  no  good  effect.  When  I  first  saw  her,  she  could  not  walk 
without  assistance.  Upon  examination,  I  found  a  considerable  e.r-curvature, 
involving  the  third,  fourth,  and  fifth  vertebrse  of  the  back, — which  vertebras 
were  also  painful  and  enlarged,  and  the  skin  which  covered  them  was  red 
and  shining.  The  patient  was  extremely  dispirited,  shed  tears  on  the  most 
trilling  occasion,  and  was  subject  to  tremblings  and  spasms.  She  was  gene- 
rally chilly,  and  suffered  much  from  coldness  of  feet.  She  also  complained 
of  flushes.  Some  days  she  thought  the  "  swelling"  in  her  back  was  not  so 
great  as  upon  others  ;  and  upon  these  particular  days,  she  also  remarked  her 
spirits  were  not  so  low.  I  directed  the  issues  to  be  discontinued,  and  ordered 
a  combination  of  hydrocyanic  acid  and  tincture  of  cantharides,  to  be  taken 
three  times  a-day.  These  medicines  she  had  scarcely  continued  a  fortnight, 
when  the  improvement  in  her  general  appearance  was  most  decided  ;  the 
protuberant  part  of  her  spine  had  in  that  period  considerably  diminished — 
her  health  daily  became  better,  and  in  less  than  a  month  ber  cure  was  accom- 
plished. A  permanent  curve,  slight  when  compared  with  her  former  state, 
still  remains. 

Case  2. — A  young  gentleman,  nine  years  of  age,  had  external  curvature  of 
the  upper  vertebrse  of  the  back ;  one  or  more  of  which  were  in  a  diseased 
and  even  ulcerated  state,  as  *vas  obvious  from  the  discharge  which  pro- 
ceeded from  an  opening  connected  with  the  spine.  His  mother  observed  that 
he  stood  more  erect  some  days  than  others.  "When  I  was  first  consulted  he 
had  an  issue  on  each  side  of  the  spine  :  but  these,  as  in  the  former  case, 
having  been  productive  of  no  good,  I  ordered  to  be  discontinued.  Keeping 
in  view  the  remittent  and  constitutional  nature  of  the  disease,  I  prescribed 
small  doses  of  calomel  and  quinine.  The  very  next  clay  the  discharge  was 
much  diminished,  and  a  cure  was  obtained  in  about  six  weeks.  The  ulcer 
in  that  time  completely  healed  up,  but  a  permanent  angular  curve,  of 
course,  remained — trifling,  however,  when  compared  with  the  state  in  which 
I  first  found  him.  I  might  give  you  many  other  such  cases,  but  my  object 
is  to  illustrate  a  principle,  not  to  confuse  you  with  too  much  detail.  These 
two  cases,  Gentlemen,  are  sufficient  to  show  you  the  nature  and  best  mode 
of  treating,  what  you  may  call,  if  you  please,  Vertebral  Consumption ; 
though  I  am  not  so  sure  the  schools  will  agree  with  you  in  the  designation. 
The  one  case  was  in  its  incipient  state,  the  other  fully  developed. 

It  occasionally  happens  that  the  matter  proceeding  from  a  diseased  verte- 
bra, instead  of  making  its  way  out  by  the  back,  proceeds  down  in  front  of 
the  loin  internally,  till  it  reaches  the  groin,  where  it  forms  a  tumour ;  this 
tumour  is  called  by  the  profession  Lumbar,  or  Psoas,  abscess.  With  the  ex- 
ception of  opening  the  tumour  to  allow  the  collection  of  purulent  or  other 
matter  to  escape,  this  disease,  like  the  cases  just  detailed,  should  be  treated 
almost  entirely  by  constitutional  measures — by  such  measures  as  tend  to  the 
improvement  of  the  health  generally.  It  has  been  for  some  time  the  fashion 
to  confine  patients  with  spinal  disease  to  a  horizontal  posture  ;  and  a  rich 
harvest  makers  of  all  sorts  of  beds  and  machines  have  derived  from  the  prac- 
tice. In  the  greater  number  of  cases  this  treatment  is  erroneous  from  begin- 
ning to  end.  Constant  confinement  to  one  posture  is  sufficient  of  itself  to 
keep  the  patient  nervous  and  ill ;  while  his  own  feelings  and  wishes  are,  for 
the  most  part,  the  best  guide  as  to  whether  he  should  rise,  walk,  sit,  or  lie 
down.     In  this  he  has  no  theory — the  doctor  too  often  has  nothing  else. 

Among  the  numerous  causes  of  spinal  disease  named  in  books,  much  stress 
is  generally  laid  on  the  improper  use  of  Stays,  and  other  articles  of  female 
dress.  To  these,  however,  I  attribute  but  a  very  small  share  in  the  produc- 
tion of  such  disorder.  You  meet  with  every  kind  of  spinal  disease  in  boys, 
— in  girls,  more  frequently,  it  is  true ;  but  this  greater  frequency  depends 


52  LECTURE  II. 

upon  the  artificial  lives  girls  are  compelled  to  lead,— their  domestic  occupa- 
tions confining  them  more  to  the  house,  and  allowing  them  less  freedom  of 
general  movement,  and  fewer  opportunities  of  enjoying  the  exercises  and  in- 
vigorating sports  of  the  open  air. 

Equally  effective  have  I  found  the  chrono-thermal  principle  of  treatment 
in  that  particular  palsy  of  one  or  more  muscles  of  the  eye-hall,  which  gives 
rise  to  Squint,  or  Strasbismus,  as  the  Faculty  phrase  it.  Parents,  who  have 
children  thus  affected,  will  tell  you  that  the  little  patients  some  days  scarcely 
squint  at  all.  You  see,  then,  that  this  affection,  at  the  commencement  at 
least,  is  in  most  instances  an  intermittent  disease.  Can  the  intermission  here, 
like  that  ot  the  ague,  be  prolonged  to  an  indefinite  period  by  bark,  opium, 
&c.  ?  Oh,  I  could  give  you  half-a-hundred  instances  where  I  have  pro- 
longed it  to  a  cure  by  these  remedies  !  In  a  case  lately  under  my  care,  the 
squint  came  on  regularly  every  alternate  day  at  the  same  hour,  and  lasted  an 
hour.  The  subject  of  it,  a  boy  of  eleven,  after  taking  a  few  minute  doses  of 
quinine,  never  squinted  more.  In  another  case,  as  nearly,  as  possible  the 
same,  I  ran  through  almost  all  the  chrono-thermal  medicines  ineffectually ; 
but  succeeded  at  last  with  musk.  I  was  lately  consulted  in  the  case  of  a 
young  gentleman  affected  with  squint,  who  had  also  a  tendency  to  curved 
spine.  A  few  doses  of  calomel  and  quinine  cured  him  of  both.  The  subject 
of  all  these  cases  had  corporeal  chills  and  heats, — showing  clearly  that  the 
local  affections  were  merely  developements  of  remittent  fever.  Were  medi- 
cal men  only  to  attend  a  little  more  to  constitutional  signs,  they  would  not,  I 
am  sure,  leech,  blister,  and  cup  away  at  localities,  as  they  are  in  general  too 
fond  of  doing.  If  properly  treated  at  the  commencement,  Squint  is  very 
generally  curable  by  internal  remedies ;  but  when,  from  long  neglect 
or  ill-treatment,  it  has  become  permanent,  the  position  and  appearance 
of  the  eye  may  be  made  all  but  natural  by  a  surgical  division  of  the  opposite 
muscle.  If  the  squint  be  partial  only,  a  surgical  operation  will  make  the 
patient  squint  worse  than  ever — and  even  in  the  case  of  complete  squint, 
should  the  paralytic  muscle  upon  which  it  depends  recover  its  power  after 
the  operation,  a  new  squint  would  follow  of  course. 

There  is  yet  another  paralytic  affection  of  the  Eye  which  I  must  explain 
to  you.  I  allude  to  what  is  called  Amaurosis,  or  Nervous  Blindness.  In 
this  case,  a  non-medical  person  could  not  tell  that  the  patient  was  blind  at 
all,  the  eye  being  to  all  appearance  as  perfect  as  the  healthy  organ.  .N'ow, 
this  affection,  in  the  beginning,  unless  when  caused  by  a  sudden  blow  or  shock, 
is  almost  always  a  remittent  disease.  Some  patients  are  blind  all  day,  and 
others  all  night  only.  Such  cases,  by  the  profession,  are  termed  Hemcralo- 
pia  and  Nyctalojria,  or  day  and  night  blindness.  These,  then,  are  examples  of 
intermittent  amaurosis  ;  and  they  have  been  cured  and  caused,  like  the  a^ue, 
by  almost  every  thing  you  can  name.  You  will  find  them  frequent  in  long 
voyages, — not  produced  in  that  case  by  exhalations  from  the  fens  or  marshes, 
as  many  of  the  profession  still  believe  all  intermittent  diseases  to  be,— but  by 
depraved  and  defective  food,  with  exposure  to  wet,  cold,  and  hard  work,  per- 
haps, besides.  In  the  Lancet,  [8th  December,  1827,]  you  will  find  the  case 
of  a  girl,  twelve  years  of  age,  who  had  intermittent  blindness  ot  both 
palsy  of  the  limbs,  frenzy,  and  epilepsy  ;  from  all  of  which  she  ro- 
under the  use  of  ammoniated  Copper,  a  chrono-thermal  remedy.  Thi 
fully  establishes  the  relations  which  these  various  symptoms  all  maintain  to 
each  other  ;  and  their  remittent  character,  together  with  the  mode  of  cure, 
explains  the  still  greater  affinity  they  bear  to  a?ue. 

The  remedies  which  I  have  found  most  efficient  in  permanent  nervous 
blindness  have  been  the  chrono-thermal,  or  ague  medicines,  occasionally  com- 
bined with  mercury,  or  creosote.  1  will  give  you  a  cue  which  I  treated  suc- 
cessfully by  an  internal  remedy.  Churls  Kmms  B  ie  that 
he  had  been  completely  blind  of  both  eye.  for  upward-  of  nine  ye:irs,  four  of 
which  he  passed  in  the  BrUtol  Asylum,  where,  after  having  been  under  the 


LECTURE  II.  53 

care  of  the  medical  officer  of  that  establishment,  he  was  taught  basket-mak- 
ing, as  the  only  means  of  earning  his  subsistence.  He  had  been  previously 
an  in-patient  in  the  Worcester  Infirmary,  under  Mr.  Pierrepoint,  but  left  it 
without  any  benefit.  Some  days  he  perceived  flasbes  of  light,  but  could  not 
even  then  discern  the  shape  or  shade  of  external  objects.  Before  he  became  com- 
pletely blind,  he  saw  better  and  worse  upon  particular  days.  When  he  first 
consulted  me,  his  general  appearance  was  very  unhealthy,  his  face  pale  and 
emaciated,  his  tongue  clouded,  appetite  defective  and  capricious  ;  and  he  de- 
scribed himself  as  being  very  nervous,  subject  to  heats  and  chills,  palpita- 
tions and  tremblings,  with  great  depression  of  spirits.  My  first  prescription, 
quinine,  disagreed ;  my  second,  silver,  was  equally  unsuccessful ;  with  my 
third,  hydrocyanic  acid,  he  gradually  regained  his  vision — being,  after  an  at- 
tendance of  four  months,  sufficiently  restored  to  be  able  to  read  large  print 
with  facility.  Such  has  been  his  state  for  upwards  of  two  years.  I  need 
not  say  his  general  health  has  materially  improved — his  appetite,  according 
to  him,  having  become  too  good  for  his  circumstances.  In  confirmation  of 
the  value  of  hydrocyanic  acid  in  nervous  blindness,  I  may  mention,  that  Dr. 
Turnbull,  in  a  recent  work,  has  detailed  some  cures  which  he  made  in  simi- 
lar cases  by  applying  the  vapour  of  this  acid  to  the  Eye. 

If  patients,  who  are  subject  to  Deafness,  be  asked  whether  they  hear 
better  upon  some  days  than  others,  the  great  majority  will  reply  in  the  affirma- 
tive ; — so  that  deafness  is  also  for  the  most  part  a  remittent  disease.  That 
it  is  a  feature  or  developement  of  general  constitutional  disorder,  is  equally 
certain,  from  the  chills  and  heats  to  which  the  great  body  of  patients  affected 
with  it,  acknowledge  they  are  subject.  Deafness  from  organic  change  of  the 
ear,  is  infinitely  less  frequent  than  that  which  arises  from  nervous  or  functional 
disorder.  Hence  the  improvement  to  be  obtained  in  the  great  majority  of 
diseases  of  this  organ,  by  simply  attending  to  the  patient's  general  health. 
By  keeping  in  view  the  chrono-thermal  principle,  I  have  been  enabled  to  im- 
prove the  hearing  in  hundreds  of  cases.  One  old  gentleman,  upwards  of  70 
years  of  age,  after  having  been  all  but  quite  deaf  for  years,  lately  consulted 
me  for  his  case  ;  he  recovered  completely  by  a  short  course  of  hydrocyanic 
acid.  The  like  good  effects  may  also  be  obtained  by  chrono-thermal  treatment 
in  ringing  of  the  ears,  &c.  Indeed,  very  few  people  get  much  out  of  health 
without  suffering  more  or  less  from  noise  in  the  ears  ;  sometimes  so  great  as 
to  cause  partial  deafness. 

Cases  of  loss  of  the  sense  of  Touch,  and  also  those  of  partial  or  general 
numbness,  will,  in  the  greater  number  of  instances,  be  found  to  exhibit  re- 
missions in  their  course.  So  also  will  almost  every  instance  of  that  exalted 
degree  of  sensibility  known  by  the  various  names  of  Tic  doloureux, 
Sciatica,  &c,  according  to  the  locality  of  the  various  nerves  supposed  to  be 
its  seat.  Look  at  the  history  of  these  diseases.  What  have  your  surgical 
tricks  done  for  their  relief, — your  moxas,  your  blisters,  your  division  of 
nerves  1  The  only  measures  to  which  these  diseases  have  yielded,  have 
been  the  chrono-thermal  remedies,  bark,  arsenic,  iron,  strychnia,  prussic  acid, 
&c,  the  remedies,  in  a  word,  of  acknowledged  efficacy  in  ague.  I  shall 
here  present  you  with  a  case  from  the  London  Medical  and  Surgical  Jour- 
nal, illustrative  of  the  nature  of  Tic  when  involving  the  nerves  of  the  face. 
The  pain  first  supervened  after  a  fright ;  it  returned  everyday  at  two  o'clock, 
commencing  at  the  origin  of  the  suborbital  nerve,  extending  along  its  course, 
and  lasted  from  half  an  hour  to  an  hour.  Two  grains  of  sulphate  of 
quinine  given  every  two  hours  for  three  days,  produced  in  so  short  a 
period  a  complete  cure.  The  same  prompt  and  favourable  effects  were 
observed  in  another  case  of  frontal  tic,  that  appeared  without  any  known 
cause.  Now,  this  frontal  tic  is  commonly  known  by  the  name  of  brow-ague. 
Why,  then,  mystify  us  with  neuropathy,  neuralgia,  and  a  host  of  other  jaw- 
breaking  terms,  that,  so  far  from  enlightening  the  student  upon  the  subject  of 
medicine,  do  nothing  but  lead  him  into  darkness  and  confusion  7  All  these 
are  mere  varieties  of  Ague  ;  the  place  of  pain  making  the  only  difference. 


54  LECTURE  II. 

Loss  of  the  sense  of  Taste  is  an  occasional  effect  of  constitutional  distur- 
bance, and  so  is  Depraved  Appetite.  An  example  of  what  is  called  Bulimia 
or  Excessive  Appetite.,  occurs  in  the  lectures  of  Mr.  Abernethy  :  "  There 
was  a  woman  in  this  hospital,  who  was  eternally  eating ;  they  gave  her  food 
enough,  you  would  have  thought,  to  have  disgusted  anybody,  but  she  cram- 
med it  all  down  ;  she  never  ceased  but  when  her  jaws  were  fatigued.  She 
found  out  that  when  she  put  her  feet  into  cold  water,  she  ceased  to  be 
hungry."  What  could  be  this  woman's  inducement  to  put  her  feet  in  cold 
water  in  the  first  instance  ?  What,  but  their  high  temperature — the  Fever 
under  which  she  laboured  ?  A  gentleman,  who  was  fond  of  play,  told  me, 
that  when  he  lost  much  money  he  was  always  sure  to  become  ravenously 
hungry ;  but  that  when  he  won,  this  did  not  happen.  The  condition  of  his 
body,  as  well  as  his  brain,  must  have  been  different  at  these  different  times. 

To  the  state  of  corporeal  temperature,  we  must  also  refer  the  various  de- 
grees of  Thirst,  from  which  so  many  invalids  suffer.  This,  like  Huwger, 
when  extreme,  is  a  depraved  sensation.  If  we  have  intermittent  fever,  80 
also  must  we  have  intermittent  hunger  and  thirst  among  the  number  of  mor- 
bid phenomena.  Colonel  Shaw,  in  his  Personal  Memoirs  and  Correspon- 
dence, has  this  remark  :  "  I  had  learned,  from  my  walking  experience,  that 
to  thirsty  men,  drinking  water  only  gives  a  momentary  relief;  but  if  the  tegs 
be  wetted,  the  relief,  though  not  at  first  apparent,  positively  destroys  the  pain 
of  thirst." 

As  yet,  Gentlemen,  we  have  confined  ourselves,  as  much  as  possible,  to 
simple  or  "functional"  diseases, — those  forms  of  disorder  in  which  there  does 
not  appear  any  tendency  to  local  disorganisation  or  decay,  in  our  next 
Lecture,  we  shall  enter  into  a  consideration  of  those  disorders  which  manifest 
more  or  less  change  of  structure  in  their  course.  Such  diseases  are  termed 
"  organic,"  by  medical  writers,  and  to  a  certain  extent  they  are  more  com- 
plicated than  those  we  have  just  left.  To  a  certain  extent,  too,  they  admit 
modification  of  treatment.  In  most  cases  of  this  kind,  though  not  in  all,  it  is 
my  custom  to  prescribe  one  or  more  powers,  having  a  general  chrono-ther 
mal  influence,  with  one  or  more  having  a  special  local  bearing.  I  have 
necessarily,  on  occasion,  combined  remedies  which  may  partially  decompose 
each  other.  In  continuing  still  to  do  so  I  am  justified  by  successful  results, 
the  only  test  of  medical  truth — the  ultimate  end  and  aim  of  all  medical  treat- 
ment. A  charge  of  unchemical  knowledge  has  been  occasionally  urged 
against  me  for  this,  by  chemists  and  drug  compounders.  But  what  says  Mr. 
Locke? — "  Were  it  my  business  to  understand  physic,  would  not  the  surer 
way  be  to  consult  nature  itself  in  the  history  of  diseases  and  their  cures,  than 
to  espouse  the  principles  of  the  dogmatists,  methodists,  or  Chemists  /"  This 
charge,  then,  I  am  willing  to  share,  with  numerous  medical  men,  whom  the 
world  has  already  recognised  as  eminent  in  their  art.  By  such,  the  answer 
has  been  often  given,  that  the  human  stomach  is  not  a  chemist's  alembic,  but 
a  living  organ,  capable  of  modifying  the  action  of  every  substance  submitted 
to  it.  And  here  I  may  mention,  that  the  late  Sir  Astley  Cooper,  when  I 
sent  him  my  work,  "  The  Unity  of  Disease,"  with  that  candour  and  gentle- 
man-like feeling  by  which  he  was  not  less  distinguished,  than  by  his  high 
eminence  as  a  surgeon,  wrote  to  me  as  follows  : — 

"  Dear  Sir,  I  thank  you  most  sincerely  for  your  valuable  work.     I  have 
not  the  least  objection  to  being  unrltcmical,  if  I  can  be  useful ;  and  I  agree 
with  you,  that  the  living  stomach  is  not  a  Wedgewood  mortar. 
Yours  truly, 

"Astley  Cooper." 

"Dr.  Dickson. 


LECTURE  III.  55 


LECTURE  III. 

hereditary  predisposition apoplexy haemorrhages heart  dis- 
ease— pulmonary  consumption glandular  complaints — con- 
sumptive diseases  of  joints. 

Gentlemen, 

We  have  hitherto  derived  our  illustrations  of  the  unity  and  intermittent 
nature  of  disease,  almostly  entirely  from  such  forms  of  disorder,  as  by  the 
profession  of  the  present  day  are  termed  functional  ;  that  is  to  say,  such 
as  are  uncomplicated  with  organic  decomposition  or  any  marked  tendency 
thereto.  Now,  in  the  commencement,  all  complaints  are  simply  functional. 
I  do  not  of  course  include  those  organic  diseases  that  have  been  the  immedi- 
ate effect  of  mechanical  or  other  direct  injury.  I  speak  of  disease  in  the 
medical  acceptation  of  that  term — disease  in  which  one  or  more  constitutional 
paroxysms  occur  before  organic  change  becomes  developed.  Inquire  the 
consequences  of  those  agues  for  which  the  usual  medical  treatment  may  have 
proved  unavailing.  Do  not  these  comprise  every  structural  change  to  which 
nosologists  have  given  a  name  ? — haemorrhage,  or  rupture  of  blood-vessels 
wherever  situated, — diseased  lungs  by  whatever  termed  ;  with  all  the  various 
visceral  alterations  which  have  obtained  designations  more  or  less  expressive 
of  the  localities  in  which  they  become  known  to  us  ;  the  enlarged,  softened, 
or  otherwise  disorganized  heart,  liver,  spleen,  and  joint ;  the  indurations  and 
other  changes  which  take  place  in  the  several  glands  of  the  body,  whether 
called  scrofulous  or  consumptive,  cancerous  or  scirrhous.  "When  patients 
thus  afflicted  complain  of  the  ague-fits,  from  which  they  suffer,  their  mediiai 
attendants  too  often  point  to  the  local  disease  as  the  cause,  when,  in  reality, 
such  local  disease  has  been  a  mere  feature  or  effect  of  repeated  paroxysms 
of  this  kind.  Even  John  Hunter,  with  ail  his  acuteness,  fell  into  this  error, 
when  he  said,  "  We  have  ague,  too,  from  many  diseases  of  parts,  more  espe- 
cially of  the  liver,  as  also  the  spleen,  and  from  induration  of  the  mesenteric 
glands."  It  is  only  of  late  years  that  the  better  informed  members  of  the 
profession  have  begun  to  suspect  that  these  structural  alterations,  instead  of 
being  the  causes  of  the  "constitutional  disturbances,"  are  the  results.  But 
this  phrase,  in  most  instances,  they  use  without  any  very  definite  idea  of  its 
meaning  ;  and  when  questioned  in  regard  to  it,  they  either  confuse  the  matter 
with  the  mixed-up  jargon  of  incompatible  theories,  or  frankly  confess  that  they 
entertain  notions  which  they  feel  themselves  unable  by  any  form  of  speech  to 
impart  to  others.  Gentlemen,  "  constitutional  disturbance,"  when  analyzed, 
will  be  found  to  be  neither  more  nor  less  than  a  morbid  excess  or  diminution 
of  the  body's  temperature,  with  corresponding  errors  in  the  various  func- 
tional powers  and  periods — amounting,  where  the  disease  is  recent  (or 
"  acute"),  to  the  bolder  features  of  intermittent  fever — and  in  cases  of 
longer  standing  (or  "  chronic"),  coming  at  last  to  the  more  subdued  symp- 
toms of  that  universal  disease.  Betwixt  these  two  extremes,  you  have  every 
kind  of  intermittent  shade,  which  shade  sometimes  depends  upon  duration, 
sometimes  upon  individual  constitution. 

Every  child  of  Adam  comes  into  the  world  with  some  weak  point,  and  this 
weak  point  necessarily  gives  the  subject  of  it  a  predisposition  to  disease  of 
one  locality  or  tissue  of  the  frame  rather  than  another  ;  but  many  persons, 
from  accidental  causes,  have  also  their  weak  points.  Of  this  kind  are  such 
parts  of  the  body,  as  after  having  been  externally  injured,  get  so  well,  that 
while  you  continue  in  health,  you  suffer  no  inconvenience  ;  but  as  old  a.:re 
steals  upon  you,  or  when  your  general  health  gives  way,  you  are  reminded 
by  certain  feelings  of  weakness  in  the  parts  injured,  of  the  accidents  that  have 
formerly  happened  to  you,  and  that  to  keep  the  affected  parts  in  tolerable 


56  LECTURE  III. 

strength,  you  must  not  play  tricks  with  your  constitution.  Individuals  so 
situated,  can  predict  every  change  of  weather;  they  are  living  barometers, 
and  can  tell  you  what  kind  of  a  day  it  shall  be,  before  they  rise  in  the  morn- 
ing. They  obtain  their  knowledge  of  this  from  the  experience  of  their  feel- 
ings in  their  old  wounds  and  fractures.  Now,  Gentlemen,  this  is  what  you 
ought  to  be  prepared  to  expect ;  the  atoms  of  repaired  parts  must  always 
have  a  weaker  attraction  to  each  other,  than  the  atoms  of  the  other  parts  of 
the  frame  ;  and  they  must,  therefore,  in  the  very  nature  ©f  things,  be  more 
liable  to  be  influenced  by  external  agency — by  every  thing,  in  a  word,  that 
has  the  power  to  put  the  matter  of  the  body  in  motion.  Whatever,  under 
ordinary  circumstances,  shall  slightly  shake  or  affect  the  whole  body,  must, 
under  the  same  circumstances,  be  a  subject  of  serious  import  to  its  weaker 
parts  ;  and  this  argument  also  applies  with  equal  force  to  the  atoms  of  those 
parts  of  individual  bodies,  which,  by  hereditary  predisposition,  manifest  a 
similar  weakness  in  the  attractive  power  of  their  atoms  to  each  other.  As 
the  child  is  but  an  extension  of  the  living  principle  of  the  parents,  its  frame 
must  naturally,  to  a  certain  degree,  partake  of  the  firmness  and  faults  which 
characterized  its  progenitors,  whether  mental  or  corporeal ;  resembling  them, 
not  only  in  external  features,  but  copying  them  even  in  their  inward  configu- 
ration. Such  similitude  we  see  extending  to  the  minutest  parts,  whether 
such  parts  be  fully  developed,  or  defectively,  or  even  superfluously  constructed. 
As  instances  of  these  last,  I  may  mention,  that  I  have  known  particular  fami- 
lies, where  the  frequent  repetition  of  six  fingers  to  the  hand  has  taken  place 
in  successive  generations,  and  others,  where  the  same  members  have  been  as 
hereditarily  reduced  beneath  the  correct  human  standard.  Then  in  regard  to 
hereditary  mental  resemblances,  you  may  see  children,  whose  father  died 
before  they  were  born,  manifesting'the  same  facility  or  stubbornness  of  temper, 
the  same  disposition  to  moroseness  or  jocularity,  which  characterized  the 
author  of  their  being.  Friends  and  relatives  will  sometimes  hold  up  their 
hands  with  astonishment  at  this  mental  likeness  of  children  to  their  parents; 
"  he  is  just  his  old  father  over  again,"  is  a  common  and  correct  mark  of  the 
least  observant.  In  the  doctrine  of  hereditary  predisposition,  then,  the  pro- 
fession and  the  public,  I  believe,  are  equally  united  in  opinion ;  but  whe- 
ther they  be  so  or  not,  is  of  very  little  import  while  you  have  eyes  to  look 
around  you,  and  can  judge  for  yourselves.  I  must,  however,  tell  you,  that, 
m  cases  of  hereditary  predisposition,  much  will  depend  upon  circumstances, 
whether  or  not  such  predisposition  be  actually  and  visibly  developed  in  the' 
individual  members  composing  a  given  family.  A  person,  for  example,  in 
whose  family  the  heart  or  lungs  is  the  weak  point,  by  guarding  himself  against 
too  rapid  changes  of  temperature,  and  availing  himself  of  a  fortunate  position 
in  society,  as  to  pecuniary  and  other  means,  may  so  control  numerous  excit- 
ing elements  of  disease,  as  to  pass  through  life"  happy,  and  comparatively 
healthy ;  while  his  less  fortunate  brother,  worn  down  by  an  accumulated 
weight  of  domestic  and  other  trouble,  shall  not  only  sujl'er  in  his  ceneral 
health,  but  shall  as  surely  have  the  weak  point  of  his  family's  constitution 
brought  out  in  his  individual  person.  We  are  all,  then,  more  or  less,  the 
"  sport  of  circumstances." 

Among  the  various  diseases,  which,  from  their  frequency,  we  justly  recog- 
nize as  the  most  prominent  and  important  that  affect  the  inhabitants  of  these 
islands,  I  may  mention,  Spitting  of  Blood,  Consumption,  mid  Glandular  dis- 
orders. The  rapid  transitions  of  temperature,  so  characteristic  of  this  climate, 
certainly  excite  these  complaints ;  for,  while  in  the  warmer  COUntries^W  the 
East,  Dysentery  and  Abscess  of  the  Liver  carry  off  the  greater  number  of 
the  various  races  that  compose  the  population,  the  natives  of  India,  who  have 
died  on  our  shores,  have  generally  fallen  victims  to  Glandular  and  Chest 
Disease.  Even  the  monkey  acknowledge*  the  baneful  effects  of  Bucb  rapid 
thermal  changes  on  his  respirator  More  than  or  class 

of  annuals  that  come  to  England,  die  of  consumption  ofthi 


LECTURE  III.  57 

of  the  chest  and  glands  certainly  become  hereditary;  but  under  that  head, 
you  may  include  a  great  many  others — epilepsy,  apoplexy,  palsv,  mania — 
and,  perhaps,  every  purely  constitutional  complaint  which  has  "obtained  a 
name.  Could  the  breeding  of  mankind  be  as  closely  watched,  and  as  easily 
controlled  as  the  breeding  of  our  domestic  animals,  incalculable  advantages, 
moral  as  well  as  physical,  might  be  the  effect  of  judiciously  crossing  particular 
races  with  each  other.  The  tendency  to  the  particular  passions  and  diseases, 
which  characterise  nations  aiul  families,  might,  in  this  manner,  be  as  certainly 
diminished,  as  the  beauty  of  the  face  and  form  might  be  exalted  in  its  standard ; 
for  both  depend  greatly  upon  hereditary  configuration,  or  upon  that  particular 
atomic  association  of  certain  parts  of  the  body,  which  you  find  prevailing  in 
families — other  external  modifying  circumstances  being,  at  the  same  time, 
kept  in  view, — such  as  climate,  temperature,  social  and  political  relationship, 
&c.  But  be  this  as  it  may^  whatever  will  agitate  the  whole  frame  of  an  in- 
dividual ;  whatever  will  in  any  manner  touch  the  strength  and  stabilitv  of 
his  corporeal  Totality,  must,  to  a  certainty,  with  much  more  severity,  affect 
the  weakest  point  of  his  body,  whatever  that  point  be.  This  doctrine  I 
mean  to  apply  to 

Apoplexy. 

The  great  system  termed  the  Human  Economy  is  made  up  of  numerous 
lesser  systems,  each  having  a  fabric  or  material  peculiar  to  itself.  By  anato- 
mists, these  various  fabrics  are  termed  the  Tissues.  Thus  we  have  the 
Osseous  or  Bony  tissue  of  the  skeleton ;  the  Cartilaginous  and  Ligamentous  tis- 
sues of  the  joints ;  the  Glanrlular  tissue,  different  in  different  systems  of  glands, 
but  without  which  there  could  be  no  secretion,  no  saliva,  no  bile,  no  perspira- 
tion, and  the  like  ;  the  muscular  and  tendinous  tissues,  so  necessary  to  loco- 
motion ;  the  Nervous  Tissue,  of  two  kinds,  one  to  convey  impressions  from  the 
brain  to  all  parts  of  the  body,  the  other  to  convey  impressions  back  to  the  brain. 
Besides  these,  there  are  certain  nerves  which  influence  growth,  termed  the 
ganglions  or  organic  nerves.  Then  there  is  the  vascular  tissue,  partly  mus- 
cular in  its  nature,  comprising  the  heart  and  its  infinity  of  blood-vessels  ;  to 
say  nothing  of  the  cellular  tissues,  which,  like  a  web  or  net,  invests  and 
insinuates  itself  into  the  whole  tissues  of  the  body.  The  tissue  of  the  lungs 
and  that  of  the  intestinal  tube  are  principally  compounded  of  the  others  ;  so, 
also,  are  the  lining  membranes  of  the  various  cavities  and  canals  that  convey 
the  secretions — "mucous  membranes,"  as  they  are  termed — for  the  membranes 
that  line  such  cavities,  such  as  the  cavities  of  the  chest  and  abdomen,  are  dis- 
tinguished by  the  term  "  serous.'"  The  Cutaneous,  or  Skin  tissue,  performs 
the  part  of  an  outward  envelope  to  all.  Now,  as  there  is  nowhere  to  be 
found  a  man  or  woman,  whose  body  is  so  perfectly  made  in  its  outward  form 
as  to  stand  the  scrutiny  of  a  sculptor  or  painter  in  all  its  parts ;  so,  in  the 
internal  configuration  of  all  bodies,  will  there  be  parts,  as  we  have  already 
seen,  inferior  to  ottfer  parts  in  strength  and  so  forth.  Some  tissue,  or  portion 
of  a  tissue,  may  be  at  fault.  Well,  then,  suppose  the  fabric  of  the  Blood- 
vessels of  a  part  to  be  the  least  strongly  constructed  tissue  of  a  given  individual, 
can  you  doubt  that  anything  which  might  injure  that  individual's  health  gene- 
rally, would,  among  other  phenomena,  develope  such  original  weakness  in 
that  part  of  his  vascular  tissue,  even  where  it  had  not  been  before  suspected  ? 
Suppose  you  were  to  starve  a  person  slowly,  or  to  bleed  him  day  by  day, 
would  you  not  in  that  case  be  sure  to  break  down  his  whole  health  ?  Would 
you  not  also  weaken  the  coats  of  the  blood-vessels  generally,  by  what  so 
palpably  weakened  every  tissue  of  the  frame  ?  Now,  suppose  one  or  more 
vessels  of  the  Brain  to  be  the  least  strongly  constructed  parts  of  an  individual 
body,  would  not  such  starvation  or  such  bloodletting  be  sure  to  produce  so 
great  a  weakness  of  the  coats  of  these  vessels  as  to  give  them  a  tendency  to 
rupture,  the  consequence  of  which  would  be  effusion  of  blood  upon  the  brain — 
in  other  words,  Apoplexy  ?     I  think  you  must  even  in  theory  come  to  tha* 


58  LECTURE  III. 

conclusion.  But,  Gentlemen,  I  will  give  you  a  fact,  or  rather  a  host  of  facts, 
which  you  will  be  glad  to  take  in  change  for  a  thousand  theories.  The 
inmates  of  the  Penitentiary  Prison,  by  very  gross  mismanagement,  were  put 
upon  a  diet  from  which  animal  food  was  almost  entirely  excluded — they  were 
all  but  starved — "  An  ox's  head  weighing  eight  pounds  was  made  into  soup 
for  one  hundred  people,  which  allows  one  ounce  and  a  quarter  of  meat  to  each 
person.  After  they  had  been  living  on  this  food  for  sometime,  they  lost  their 
colour,  flesh,  and  strength,  and  could  not  do  as  much  work  as  formerly." 
"  The  affections  which  came  on  during  this  faded,  wasted,  weakened  state  of 
body,  were  headache,  vertigo,  delirium,  convulsions,  Apoplexy."  Remem- 
ber, Gentlemen,  this  is  not  my  statement — no  distortion  or  corruption  of  words 
made  by  me  as  a  party  advocate.  It  is  a  quotation  literatim  et  verbatim  from 
the  official  report  of  Dr.  Latham,  the  physician  who  was  deputed  by  Govern- 
ment to  inquire  into  the  cause  of  the  great  mortmlity  of  the  Penitentiary.  If 
you  place  any  confidence  in  the  accuracy  of  that  report ;  if  you  believe  Dr. 
Latham  to  be  an  honest  man,  there  is  only  one  conclusion  you  can  come  to, 
which  is  this,  that  the  universal  practice  of  starving  and  bleeding  to  prevent 
or  cure  Apoplexy,  is  the  most  certain  mode  of  producing  this  disease  in  per- 
sons predisposed  to  it,  and  of  confirming  it  in  such  as  have  already  shown  the 
apoplectic  symptoms.  Gentlemen,  you  seemed  startled  at  this,  and  no  wonder, 
for  some  of  you  have,  doubtless,  lost  friends  or  relatives  by  the  practice. 
How  then,  you  demand,  must  apoplexy  be  treated  1  That  apoplexy,  like 
every  other  disease,  is  a  development  of  general  constitutional  disturbance  : 
that  it  is  in  the  first  instance  a  remittent  disease,  aud  in  many  instances  cur- 
able, by  the  remedies  so  generally  influential  in  the  treatment  of  intermittent 
fever,  according  to  the  various  stages  of  that  complaint,  I  could  prove  to  you 
by  a  multitude  of  evidence.  But  there  is  a  case  in  the  Medical  Gazette, 
which  bears  so  strongly  on  this  very  point,  that  I  will  give  it  to  you  at  length. 
It  is  from  the  pen  of  Dr.  Graves  of  Dublin,  and  the  subject  of  it  was  a  gentle- 
man riving  in  the  neighbourhood  of  Donnybrook.  This  gentleman,  Dr. 
Graves  tells  us,  "  Had  slept  well  till  four  o'clock  in  the  morning,  when  he 
was  awakened  by  a  general  feeling  of  malaise,  shortly  after  which  he  com- 
plained of  chilliness,  some  nausea,  and  headache.  [Here  then  was  the  cold 
stage.]  After  these  symptoms  had  continued  about  an  hour,  his  skin  became 
extremely  hot,  the  pain  of  the  head  intense,  and  drowsiness  was  complained 
of,  which  soon  ended  in  perfect  coma,  with  deep  snoring  and  insensibility  ;  in 
fact,  he  appeared  to  be  labouring  under  a  violent  apoplectic  fit.  He  seemed 
to  derive  much  advantage  from  bleeding,  and  other  remedies,  and  to  my  sur- 
prise was  perfectly  well  when  I  visited  him  in  the  evening.  The  day  but 
one  after,  at  the  very  same  hour,  the  very  same  symptoms  returned,  and  were 
removed  by  the  very  same  remedies.  [So  at  least  the  doctor  thought.]  I 
must  confess,"  he  continues,  "  that  I  could  not  explain  in  a  satisfactory  man- 
ner the  perfect  freedom  from  all  cerebral  and  paralytic  symptoms  after  two 
such  violent  attacks  of  Apoplexy.  But  when  a  third  attack  came  on,  I 
then  saw  it  was  a  case  of  the  Tertiana  Soporosa  [mere  jargon]  of  nosolo- 
gists,  and  I  prevented  the  return  of  the  fit  by  the  exhibition  of  quinine."  The 
quinine,  you  see,  proved  at  once  an  efficient  preventive  of  the  returning  tits, 
while  repeated  blood-letting,  whatever  might  have  been  its  effect  in  short  ru- 
ing them,  had  not  the  slightest  influence  in  that  more  salutary  respect.  But 
when  Dr.  Graves  supposed  that  his  bleedings  did  actually  shorten  the  dura- 
tion of  the  fits,  may  he  not  have  been  deceived  by  the  approaching  intermis- 
sion I  may  he  not  have  mistaken  this  natural  phenomenon  of  all  disorder  For 
the  effect  of  his  remedies?  However  that  be,  this  much  I  may  lie  permitteJ 
to  say  for  myself,  that  since  I  gave  up  the  practice  of  bleeding  in  apoplexy, 
I  have  found  that  disease  in  the  young  as  generally  curable  as  nny  other,  and 
in  the  old  much  less  fatal  than  when  treated  by  the  lancet.  Mr.  Smith,  of 
Cheshunt,  lately  informed  me  that  he  had  cured  several  cases  of  apoplexy 
simply  by  dashing  cold  water  over  the  patient's  head,  without  drawing  a  drop 


LECTURE  III.  59 

ot  blood.  Mr.  Walter,  a  surgeon  of  Dover,  has  successfully  treated  apoplexy 
by  the  same  practice.  "  The  application  of  your  theory,"  he  writes  to  me, 
"  has  lately  saved  me  from  bleeding  in  two  cases  of  apoplexy,  both  of  which 
did  well  without  it."  Now  apoplexy,  as  it  happens,  is  the  great  stumbling- 
block  of  the  vulgar.  How  mad  Dr.  Dixon  must  be  not  to  bleed  in  apoplexy  ! 
— that  is  the  language  of  every  blockhead  who,  knowing  nothing  of  the  sub- 
ject but  what  he  has  picked  up  "  in  conversation,  or  in  his  schools,"  very 
wisely  fancies  himself  an  oracle.  But  what  say  the  oracles  of  the  schools  ? 
what  say  men  who  for  years  and  years  have  been  preaching  up  blood-letting 
as  an  infallible  remedy  for  all  diseases  ?  Dr.  Clutterbuck,  as  you  all  know, 
throughout  a  long  life,  has  advocated  that  kind  of  practice  ; — what  does  Dr. 
Clutterbuck  say  of  its  success  in  cases  of  apoplexy  ?  I  almost  fear  you  will 
not  believe  I  quote  him  rightly  ;  but  the  word  "  Clutterbuck"  assuredly 
stands  at  the  foot  of  the  article  Apoplexy  in  the  Cyclopcedia  of  Medicine, 
from  which  I  quote — and  this  is  what  we  there  find  under  that  head  and 
upon  that  subject : — "  As  mere  matter  of  experience  there  is  reason  to  believe 
that  blood-letting  does  much  less  good,  and  the  omission  of  it  less  injury  than 
is  generally  supposed."  Only  imagine  the  delight  I  felt  when,  in  the  course 
of  my  desultory  reading,  I  first  stumbled  upon  this  passage.  Such  a  confes- 
sion from  such  a  quarter  !  Gentlemen,  I  laughed  most  heartily,  and  made  an 
extract  on  the  instant,  keeping  to  the  exact  words  which  1  have  now  given 
you  for  your  edification. 

That  you  may  cure  the  disposition  to 

Ruptured  Blood- Vessel  or  Hemorrhage, 

in  other  parts  of  the  body,  as  well  as  in  the  brain,  by  cold  affusion,  I  could 
give  you  an  infinity  of  proofs.  What  is  the  old  woman's  practice  in  bleeding 
from  the  nose  ?  To  put  a  cold  key  down  your  back,  and  thus,  by  the  sudden- 
ness of  the  shock  change  in  a  moment  the  whole  corporeal  temperature. — 
The  principle  is  the  same  in  both  cases,  and  the  good  effects  of  that  measure 
ought  long  ago  to  have  suggested  to  medical  practitioners  a  better  practice  in 
apoplexy  and  other  haemorrhages,  than  is  at  present  the  fashion  with  fashion- 
able doctors.  Cold  water,  Gentlemen,  has  many  virtues,  but  a  great 
deal  depends  on  the  mode  of  its  application.*  The  suddenness  of 
the  dash  is  the  chief  thing  to  be  attended  to  in  cases  of  haemorrhage  disease. 
So  much,  then,  for  the  proper  treatment  of  the  patient  during  the  fit  of  bleed- 
ing ;  but  what  is  to  be  done  to  prevent  its  return  ?  English  practitioners 
almost  to  a  man  starve,  bleed,  and  purge  you.  The  following  case  may  open 
their  eyes  ;  and  as  it  is  not  taken  from  my  own  experience,  but  from  a  German 
medical  journal  of  repute,  it  may  perhaps  carry  more  weight  with  it  on  that 
account.  "A  strong  man,  aged  27,  suffered  on  alternate  days  from  very 
violent  bleeding  at  the  nose,  which  continued  from  four  to  six  hours,  and  could 
neither  be  stopped  nor  diminished  by  the  usual  styptics,  nor  by  any  of  the 
other  means  commonly  employed  in  similar  cases.  Taking  into  account 
the  remarkable  periodicity  of  the  bleeding,  the  treatment  was  changed  for  a 
large  dose  of  sulphate  of  quinine  with  sulphuric  acid.  During  the  twenty- 
one  days  following,  the  bleeding  recurred  but  twice,  and  was  then  readily 
stopped.  The  patient  subsequently  continued  quite  well."  —  [Medical 
Zeitung,  No.  33,  1836.] 

In  the  case  of  a  young  lady  afflicted  with  periodical  vomiting  of  blood,  for 
which  she  had  been  repeatedly  bled  without  the  smallest  advantage — or  rather 
to  the  great  injury  of  her  general  health — I  effected  a  rapid  cure  with  a  com- 

*  When  the  words  I  have  placed  in  capitals  in  the  text  were  first  printed,  Hydropathy,  or  the  cold 
water  cure,  was  not  even  known  by  name  in  England.  Practised  on  a  right  principle.  Hydropathy 
is  only  a  fragmeutal  part  of  Chrono-Thermal  means.  But  while  Priesnitz  and  his  followers 
reject  all  remedies  that  God  has  given  us  but  cold  water;  I,  on  the  contrary,  avail  myself  of  every 
good  thing  in  nature,  cold  water  included.  Fertility,  not  paucity,  of  resource,  should  be  the  ahn  of 
the  enlightened  practitioner. 


60  LECTURE  III. 

bination  of  quinine  and  alum.  The  same  disease  I  have  again  and  again  cured 
by  arsenic,  opium,  and  Prussic  Acid.  A  captain  of  the  royal  navy,  whom  1 
lately  attended  along  with  Mr.  Henry  Smith,  of  Cheshunt,  for  vomiting  of 
blood,  got  well  by  small  doses  of  copper  and  the  application  of  wet  cloths  to 
his  stomach. 

You  will  now,  I  have  no  doubt,  be  prepared  to  question  the  propriety  of 
the  usual  murderous  treatment  adopted  for  spitting  of  blood — pulmonary  apo- 
plexy, as  it  has  been  called.  Is  not  the  lancet  in  almost  every  such  case 
the  first  thine:  in  requisition,  and  death  the  almost  as  inevitable  result  of  the 
measure  ?  What  say  the  older  authors  upon  this  matter  1  Listen  to  He- 
berden,  a  physician,  who,  for  upwards  of  thirty  years,  had  the  highest  and 
most  extensive  practice  in  London  :  "  It  seems  probable,"  writes  this  veteran 
in  medicine,  '•  from  all  the  experience  I  have  had  of  such  cases,  that  where 
the  haemorrhage  proceeds  from  the  breach  of  some  large  vein  or  artery,  there 
the  opening  of  a  vein  will  not  stop  the  efflux  of  blood,  and  it  will  stop  without 
the  help  of  the  lancet,  when  it  proceeds  from  a  small  one.  In  the  former  case, 
bleeding  does  no  good :  and  in  the  latter,  by  an  unnecessary  waste  of  the 
patient's  strength,  it  will  do  harm.  But  if  the  opening  of  a  vein  be  intended 
to  Btop  a  haemorrhage,  by  deprivation  or  revulsion,  may  it  not  be  questioned 
whether  this  doctrine  be  so  clearly  established,  as  to  remove  all  fears  of  hurt- 
ing a  person  who  has  already  lost  too  much  blood,  by  a  practice  attended  by 
the  certain  loss  of  more?"  With  which  reasoning,  I  hope  you  are  all,  bj' 
this  lime,  prepared  to  agree.  But  men  who  know  nothing  of  the  economy  of 
the  human  system,  will  sometimes  dispute  this  matter  wirh  you,  by  saying, 
that  their  patients  make  blood  so  fast,  that  they  must  periodically  bleed  them, 
to  keep  down  the  disposition  to  haemorrhage.  Gentlemen,  these  practitioners 
deceive  themselves  ;  they  are  deluded  into  this  false  and  fatal  practice  by  the 
returning  febrile  fit — a  fit  that  will  recur  and  re-recur  at  more  or  less  regular 
periods,  while /here  are  blood  and  life  in  the  body;  and  the  more  frequent  the 
bleedings  practised  in  the  case  the  more  frequently  will  this  febrile  fit  come  on, 
and  with  it,  the  very  haemorrhage  which  it  is  the  object  of  their  solicitude  to 
prevent.  Does  it  not  stand  to  reason,  that  the  more  you  debilitate  the  ichole 
body,  the  more  must  you.  at  the  same  time,  weaken  the  already  too  weak 
tissue  of  the  vascular  coats — that  tissue  whose  original  weakness  con- 
stitutes the  tendency  to  haemorrhage!  Instead  of  being  the  consequence  of 
any  constitutional  plenitude  of  the  blood  itself,  spitting  of  blood  is  only  a 
natural  effect  of  real  weakness  in  the  coats  of  the  containing  vessels  of  the 
lungs  ;  so  that  not  only  is  the  theory  of  making  too  much  blood  absolute  non- 
sense, but  the  measures  which  medical  men  have  for  centuries  been  putting 
in  force,  for  the  cure  of  haemorrhage  diseases  generally,  have  been  one  and 
all  as  fatal  in  their  tendency,  as  the  theory  that  led  to  them  was  in  principle 
false.  Look  at  the  pale  and  exsanguine  countenances  of  the  unfortunate  indi- 
viduals, who,  whether  for  spitting  of  blood,  apoplexy,  or  other  haemorrhages, 
have  been  subject  to  such  cruel  discipline,  and  tell  me  if  these  poor  creatures 
make  too  much  blood  ?  Too  much  blood  ! — only  place  your  finger  on  the 
artery  of  the  wrist,  and  you  may  feel  it  jerking,  and  compressible,  like  t  hat 
of  a  female  who  has  suffered  from  repeated  flooding!.  Even  during  the 
febrile  paroxysm,  you  may  sec  by  the  circumscribed  flush  of  the  face,  thai  the 
patient  is  actually  dying  of  hectic  or  inanition.  What  fatal  mistakes  have 
not  originated  in  this  notion  of  making  too  much  blood  ?  To  hired  in  the  case 
of  a  ruptured  blood-vessel,  then,  is  positive  madness.  If  you  open  a  vein  in 
the.  arm  of  any  man,  whether  healthy  or  the  reverse,  and  let.  blond,  will  the 
opening  of  another  vein  Btop  the  flew  of  blood  from  the  vein  first  opened  1 
So  far  from  that,  both  veins  will  go  on  bleeding  till  the  patient  either  faint  or 
die  !  Should  not  this  fact  have  long  ago  opened  the  eyes  of  the-  profession  to 
tin-  fallacy  of  their  practice!  ?  Gentlemen,  how  can  you  doubt,  thai  th 
of  tin  blood-vessels,  like  every  other  tissue  of  the  body,  must  be  implicated  i:i 
the  general  debility  produce,!    by  whatever  abstracts  from,  or  prevcnl 


LECTURE  III.  61 

entrance  of,  the  material  necessary  to  the  healthy  organisation  of  every  part 
of  the  human  frame  ?  To  bleed  or  starve  a  person  having  a  hereditary  pre- 
disposition to  spitting  of  blood  or  apoplexy,  is  the  most  certain  method  to  de- 
velop these  diseases  in  their  worst  forms  !  Yet  this  is  the  daily  practice  of 
the  most  eminent  physicians  !  one  among  many  proofs,  that,  in  the  medical 
profession,  eminence  is  less  frequently  attained  by  successful  results  in  prac- 
tice, than  by  the  dexterous  employment  of  all  those  arts  and  intrigues  with 
which  mediocre  but  unscrupulous  minds  too  often  beat  men  of  genius  in  the 
race.  So  far  as  practice  is  concerned,  the  eminent  physician  generally  con- 
fines himself  to  the  fashion  of  the  day — the  more  especially,  if  that  fashion  be 
profitable  to  the  apothecary  ;  for  in  such  cases  he  is  sure  to  become  the 
fortunate  puppet  of  those  whose  bread  depends,  not  so  much  upon  the  cures 
they  shall  effect,  as  the  quantity  of  physic  they  shall  manage  to  sell !  What 
a  happy  nation  of  fools  must  that^  be,  which  suppose  that  any  class  of  man- 
kind will  put  the  interests  of  the  public  in  competition  with  their  own  ! — 
Benighted  and  misguided  people  !  you  call  upon  men  to  relieve  you  from  your 
sufferings,  while  you  hold  out  to  them  the  most  powerful  of  temptations  to 
keep  you  on  your  sick  beds  !  You  pay  for  time,  what  you  deny  to  talent ; 
for  a  long  illness,  what  you  refuse  to  a  speedy  recovery  !  Do  you  think 
medical  men  angels,  that  you  thus  tamper  with  their  integrity  ?  Your  very 
mode  of  remunerating  them  almost  forces  them  to  be  corrupt — and  that,  too, 
at  a  moment  when  their  numbers  are  so  great,  it  is  utterly  impossible  for  one 
half  of  them  to  live  honestly  on  their  mere  professional  gains.  Hear  Mr.  Aber- 
nethy  on  this  subject: — "  There  has  been  a  great  increase  of  medical  men, 
it  is  true,  of  late  years  ;  but,  upon  my  life,  diseases  have  increased  in  propor- 
tion."    He  might  have  added, — "  And  they  are  longer  of  being  cured." 

To  return  to  the  subject  of  Ruptured  Blood-vessel.  You  will  find  that  in 
every  case,  except  where  it  has  been  produced  by  mechanical  or  other  local 
agency,  this  disease  is  the  effect  or  developement  of  general  intermittent 
fever  ;  the  symptoms  of  which  fever  vary  in  their  degree  of  severity  with 
every  case, — in  one  being  bold  and  well  marked  ;  in  another,  so  softened  and 
subdued,  as  almost  to  escape  the  patient's  own  observation  ; — curable,  too,, 
like  the  simplest  ague,  by  the  cold  dash  or  an  emetic  given  during  the  hot  fit ; — 
and  to  be  prevented  from  recurring  by  chrono-thermal  treatment  during  the 
interval  of  remission.  One  case  will  yield  to  opium  or  arsenic,  another  to 
copper,  quinine,  or  prussic  acid,  and  some  few  will  trouble  you  to  cure  them 
at  all — for  what  will  agree  with  one  constitution,  may,  as  we  have  too  often 
seen,  disagree  with  another.  I  could  give  dozens  of  cases  of  every  kind  of 
constitutional  haemorrhage  cured  in  this  manner  ;  but  the  details  of  one 
would  be  the  details  of  all.  Yes,  Gentlemen,  I  repeat,  by  the  early  use  of 
emetics,  the  proper  application  of  heat  and  cold  in  the  different  morbid  con- 
ditions of  the  body  constituting  the  febrile  Jit,  and  by  the  judicious  exhibition 
of  the  chrono-thermal  medicines  during  its  remission,  I  have  successfully 
treated  every  kind  of  hemorrhagic  disease.  The  same  system  of  treatment 
has  enabled  me  effectually  to  cure  many  cases  of  Enlarged  Veins — Varicose 
Veins,  as  they  are  termed — and  the  mention  of  this  recalls  to  my  recollection 
the  case  of  an  aged  female  who  had  a  painful  varicose  ulcer — that  is,  a  sore 
with  blood-vessels  opening  into  it — for  which  I  prescribed  the  internal  use  of 
arsenic,  with  almost  immediate  relief  to  her  pain,  and  the  subsequent  cure  of 
her  ulcer.  From  the  happy  result  of  that  and  other  similar  cases,  the  sur- 
gical mechanic  may  learn  that  there  are  other  and  better  modes  of  treating 
"  varicose  veins,"  than  by  bandages  and  laced  stockings.  Well,  then,  I  have 
said  all  I  mean  to  say  upon  the  subject  of  Haemorrhage,  and  I  have  antici- 
pated something  of  what  naturally  belongs  to  the  treatment  of  Diseases  of 
the  Chest.     Of  these  I  must  now  speak  at  some  length. 

It  has  ever  been  the  policy  of  teachers  and  professors  to  affect  to  penetrate 
farther  into  a  millstone  than  their  pupils ;  and,  seeing  that  for  the  most  part 
such  professors  know  as  little  of  their  particular  subject  as  those  they  pre- 


62  LECTURE  III. 

tend  to  enlighten  upon  it,  so  far  as  their  own  reputation  is  concerned,  they 
are  doubtless  right !  The  great  medical  millstone  of  the  present  day  is  the 
Chest, — and  Laennec's  bauble,  the  divining  rod  by  which  our  modern  sages 
pretend  to  have  obtained  their  knowledge  of  it.  If  you  believe  them,  a  hollow 
piece  of  stick  they  have  nicknamed  "  the  Stethoscope,"  is  the  greatest  invention 
of  these  times  !  By  means  of  it  you  may  discover  every  motion  and  change  of 
motion  that  ever  took  place  in  the  organs  within  the  cavity  of  the  chest,  and 
some  that  never  could  take  place  in  them  at  all.  What  an  invaluable  instrument 
must  it  be,  that  stethoscope  !  The  enchanter's  wand  was  nothing  to  it  ! 
But.  seriously  speaking,  just  observe  how  gravely  your  hospital  tyros  hood- 
wink and  hocus  each  other  with  the  phrases  "  hypertrophy"  here,  and 
"  atrophy"  there  ;  "caverns"  in  this  place,  and  "  congestions"  in  that — to 
say  nothing  of  "  rhoncus"  and  "rale,"  "egophony"  and  "  sybilus" — and 
heaven  knows  what  other  sounds  and  signs  besides — sounds  and  signs  which, 
in  the  greater  number  of  cases,  have  as  much  of  truth  and  reality  as  the  roar 
of  the  "sea  with  which  the  child  deludes  his  fancy,  when  holding  a  shell  to 
his  ear  ! 

Let  me  first  speak  to  you  of 

Diseases  of  the  Heart. 

Do  not  the  subjects  of  every  kind  of  Heart-affection  tell  you  they  are  one 
day  better,  another  worse  ?  How  shall  we  speak  of  diseases  of  this  organ  ? 
of  palpitation  and  temporary  cessation  or  remission  of  its  action  ? — disorders 
constantly  misunderstood,  and  as  constantly  maltreated.  Complain  but  of  flut- 
ter or  uneasiness  in  any  part  of  the  Chest,  the  stethoscope — the  oracular  stetho- 
scope— is  instantly  produced.  Astonished — in  many  instances  terrified — the 
patient  draws  his  breath  convulsively — his  heart  beats  rapidly — and  the  in- 
dications obtained  by  means  of  this  instrument,  at  such  a  moment  of  doubt, 
anxiety,  and  fear,  are  registered  and  recognised  as  infallible.  "  Have  we  not 
had  too  much  talk  of  Heart-Disease  since  the  stethoscope  has  come  so  gene 
rally  into  vogue?"  That  was  a  question  asked  some  years  ago  by  the  late 
Dr.  Uwins.  Let  Dr.  James  Johnson  answer  it.  For  reasons  which  I  shall 
by-and-byfi  make  you  acquainted  with,  I  prefer  his  evidence  here  to  that  of 
any  other  physician.  In  one  of  the  numbers  of  the  Lancet,  he  is  stated  to 
have  said  at  a  Medical  Society  : — "  It  was  a  common  error  in  young  practi- 
tioners to  consider  the  heart  as  organically  diseased  when  its  functions  only 
were  much  interfered  with,  and  this  error  has  become  more  general,  he  was 
sorry  to  say,  since  the  stethoscope  has  come  into  use."  Dr.  Johnson  con- 
fines his  observation  to  young  practitioners — himself  not  coming  under  that 
head — but  I  have  seen  men  as  old  as  he  make  the  same  mistake,  and  those, 
too,  enjoying  a  great  reputation  for  stethoscopic  sagacity- 
Patient  after  patient, — medical  as  well  as  non-medical, — have  come  to  me 
with  the  fatal  scroll  of  the  stethoscopist — their  hearts  palpitating,  their  limbs 
trembling,  as  they  gazed  in  my  face,  expecting  to  read  there  nothing  short 
of  a  confirmation  of  their  death-warrants  ;  yet  of  these  patients,  many  are  now 
living  and  well,  and  laugh,  as  I  hope  to  make  you  laugh,  at  both  the  instru- 
ment and  its  responses.  How  little  must  that  man  know  of  his  duty  as  a 
physician,  who  would  deprive  a  fellow  creature  in  distress  of  the  balm  of 
hope — how  little  can  he  appreciate  the  influence  of  the  depressing  passions 
on  the  bodily  sufferings  of  the  sick  !  Yet  with  these  eyes  have  I  seen,  in  the 
hands  of  the  patient,  the  written  announcement  of  bis  doom,  an  announce- 
which  afterwards  turned  out  to  be  utterly  anpropbetic  and  false.  How 
unwarrantable  in  any  case  to  intrust  the  patient  with  such  a  document ! 

Lei  rhe  practitioner  withdraw  bis  eye,  for  a  rime,  from  a  mere  symptom  ; 
let  him  observe  bow  other  muscles  of  his  patient  palpitate  at  times,  like  the 
heart,  and  act,  like  that,  convulsively  :  rinding  these  Bymptoma  to  be  remit- 
tent in  every  case,  and  complicated  with  others,  all  equally  remittent,  would 


LECTURE  III.  63 

he  still  persist  in  his  small  bleedings,  his  repeated  leeches,  his  purges — mea- 
sures of  themselves  sufficient  for  the  production  of  any  and  every  degree  of 
organic  change,  he  already  fancies  he  has  detected  !  Would  he  not  rather 
reflect  with  horror  on  his  past  treatment,  and  endeavour,  by  another  and  a 
better  practice,  to  enable  his  patient  to  escape  the  sudden  death  to  which,  in 
his  imagination,  he  had  devoted  him  ?  How  many  a  physician,  by  such  a 
prognostic,  has  obtained  unmerited  credit  for  foresight  and  sagacity,  while  he 
only  taught  the  patient's  friends  to  be  prepared  for  an  event,  he  himself  was 
materially  contributing  to  hasten  !  Truly,  in  this  case  at  least,  prophecies 
do  tend  to  verify  themselves  ! 

Gentlemen,  I  have  seen  two  stethoscopists  examine  a  patient  with  sup- 
posed Heart-disease,  and  come  to  the  most  opposite  conclusions, — one  de- 
claring the  organ  to  be  enlarged,  the  other  assuming  with  equal  confidence 
that  it  was  the  reverse  !  The  utter  absurdity  of  attempting  to  distinguish, 
during  life,  one  form  of  Heart-affection  from  another  by  any  particular  sign 
or  symptom,  is  sufficiently  proved  by  this  one  fact,  that  mere  functional  va- 
riation of  its  motions  may  produce  every  symptom  of  a  real  change  in  the 
structure  of  the  organ  itself.  But  even  could  such  a  distinction  be  effected 
to  the  nicety  of  a  hair,  the  knowledge  of  it  would  not  be  worth  a  rush  for  any 
•practical  purpose  ;  inasmuch  as  the  remedies  for  every  kind  of  chest-disease 
come  at  last  to  the  same  agency,  whether  that  agency  be  directly  applied  to 
the  surface  of  the  body  in  the  shape  of  cold  or  heat,  or  be  externally  or  in- 
ternally administered  in  the  form  of  medicines  that  electrically  influence  the 
corporeal  motions  through  the  medium  of  the  brain  and  nerves.  By  the 
chrono-thermal  system  of  practice,  I  have  successfully  treated  every  kind  of 
Heart-disease  which  ever  came,  or  could  come,  under  the  notice  of  the  phy- 
sician— setting  aside,  of  course,  original  malformation  of  the  organ.  I  will 
give  you  some  cases  in  illustration  : — 

A  gentleman,  age  30,  had  been  ill  for  a  long  time,  particularly  complain- 
ing of  his  heart,  the  action  of  which  organ  was  generally  below  the  healthy 
standard,  and  it  also  palpitated  occasionally.  So  great  was  his  mental  de-. 
pression,  that  tie  smallest  trifle  produced  tears.  The  temperature  of  his 
body  generally  was  below  that  of  health,  and  he  suffered  much  from  coldness 
of  feet;  remissions  he  of  course  had,  being  better  at  particular  times.  As 
he  did  not  improve  in  the  country,  he  thought  he  would  try  a  London  doc- 
tor ;  so  he  came  to  town  and  consulted  the  late  Dr.  Hope,  author  of  a  work 
on  "  Diseases  of  the  Heart."  The  stethoscope  in  this  case  was  as  usual  ap- 
plied to  the  chest ;  its  annunciation  was  sepulchral.  Hope  here  told  no 
"  flattering  tale,''  for  not  only  was  the  heart  pronounced  to  be  enlarged,  but 
a  fatal  result  was  prophetically  expressed.  The  treatment  prescribed  was 
not  ill  calculated  to  verify  the  prediction — carscarilla  and  ammonia, — with 
aperients  !  and  a  bleeding  every  month,  or  six  weeks  !  !  The  patient's 
health,  as  you  may  readily  suppose,  got  worse  and  worse  daily ;  he  became 
much  emaciated  in  his  person,  and  completely  prostrate  in  mind.  To  sum 
up  all,  he  had  a  tendency  to  fainting  fits ;  in  which  state,  by  the  advice  of 
Dr.  Selwyn  of  Ledbury,  he  eame  to  me.  You  already  guess  the  practice  I 
adopted — chrono-thermal,  of  course.  Yes,  Gentlemen,  I  ordered  him  first  a 
combination  of  prussic  acid  and  creosote,  which  I  afterwards  followed  up  by 
arsenic  and  quinine.  I  also  prescribed  a  generous  diet,  with  wine.  Well, 
what  was  the  effect  of  tjris? — Why,  notwithstanding  the  depletion  to  which 
he  had  been  subjected,  he  improved  daily,  and  in  about  six  weeks  had  be- 
come so  well  as  to  be  able  to  resume  his  profession — the  law,  which  he 
had  been  obliged  to  leave  off.  Indeed,  a  letter  I  afterwards  received  from 
Dr.  Selywn,  gave  me  the  news  of  his  marriage.  Yet  this  patient,  according 
to  the  stethoscope,  should  have  been  dead  and  buried  long  ago ! 

Gentlemen,  in  confirmation  of  the  value  of  Arsenic  in  disease  of  the  heart, 
the  details  of  a  case  from  Darwin,  who  wrote,  be  it  remembered,  in  the  last 
century,  may  not  be  deemed  unimportant : — "  A  gentleman,  65  years  of  age, 


64  LECTURE  III. 

had  for  about  ten  years  been  subject  to  an  intermittent  pulse,  and  to  frequent 
palpitations  of  his  heart.  Lately  the  palpitations  seemed  to  observe  irregu- 
lar periods,  but  the  intermission  of  every  third  or  fourth  pulsation  was  almost 
perpetual.  On  giving  him  four  drops  of  a  saturated  solution  of  Arsenic  about 
every  four  hours,  not  only  the  palpitation  did  not  return,  but  the  intermis- 
sion ceased  entirely,  and  did  not  return  so  long  as  he  took  the  medicine." 

The  cases  I  shall  now  give  are  three  of  many  such  which  have  occurred 
in  my  own  practice  : — 

_  Case  1.— A  young  lady  was  afflicted  with  palpitation  of  the  heart,  occa- 
sional cough,  and  so  great  a  difficulty  of  breathing  as  to  be  unable  to  sleep, 
except  when  supported  with  pillows.  She  had  frequent  shivering  fits;  her 
abdomen  and  legs  were  much  swelled,  and  her  symptoms  altogether  so  dis- 
tressing, as  to  leave  her  friends  with  scarcely  a  ra"y  of  hope.  Nevertheless, 
by  the  employment  of  silver,  quinine,  and  prussic  acid,  she  did  eventually 
recover,  to  the  surprise  of  all  who  knew  her.  Remissions  were  well 
marked  in  this  case. 

Case  2.— A  young  gentleman,  aged  16,  had  violent  palpitation  of  the  heart, 
headache,  craving  appetite,  and  some  thirst,  with  great  depression  of  spirits. 
He  was  much  emaciated,  and  had  a  tendency  to  eruption  of  the  skin.  His 
hands  and  feet,  which  were  generally  cold  by  dav,  became  during  the  night 
so  hot,  as  frequently  to  keep  him  from  sleeping.  "By  a  course  of  cold-plunge 
baths,  alternated  with  the  shower  bath,  and  by  the  use  at  the  same  time  of 
quinine  and  iron  in  combination,  this  young  gentleman  was  completely  re- 
stored to  health— every  one  of  the  above  symptoms  having  disappeared  in  a 
few  weeks.  He  is  now  serving  with  his  regiment  in  India,  having  reached 
the  rank  of  lieutenant. 

Case  3.— Major  M'P 's  heart  palpitated  so  violently  at  times,  that  vou 

could  see  the  motions  in  a  distant  part  of  the  room.  This  was  the  rase 
when  I  was  asked  to  see  him.  I  ordered  him  prussic  acid  and  musk,  which 
stopped  the  palpitation  in  about  two  minutes  after  he  took  it.  In  the  middle 
of  the  night  he  had  a  threatening  of  the  complaint,  but  it  was  at  once  arrested 
by  the  same  medicines.  A  continuation  of  them  for  about  Six  weeks  cured 
him  completely. 

Before  dismissing  affections  of  the  Heart,  I  must  tell  you  that  the  greater 
number  of  these  complaints  depend  less  on  any  defect  in  that  organ  than  upon 
a  weakness  or  want  of  power  in  the  Brain  to  control  the  motions  of  the  heart 
— and  of  this  you  may  easily  convince  yourselves  by  putting  the  question  to 
the  patient:  How  do  you  feel  when  anything  disturbs  your  mind?  The 
answer  will  almost  invariably  be,  "  Oh,  it  brings  on  the  palpitation  at  once," 
or  the  pain,  as  the  case  may  be.  Gentlemen,  strengthen  the  brain,  and  in 
few  instances  will  you  have  any  trouble  about  the  heart.  The  Brain  is  the 
great  controller  of  every  function — it  is  the  true  key  to  all  good  treatment. 

We  now  come  to  consider 

Pulmonary  Consumption,  or  Decline. 

When  you  see  a  person  harassed  with  cough,  and  losing  his  flesh,  and  if, 
at  the  same  time,  he  complain  of  shortness  of  breath  and  pain  of  the  chest, 
and  begin  to  expectorate  a  muco-purulent-looking  matter,  you  may  certainly 
Bet  down  that  man's  disease  as  Consumptive ;  for  not  only  is  the  general 
health  in  that  case  manifestly  wrong,  but  the  lungs  are  more  or  less  implicated 
— and  what  does  it  signify  in  which  of  their  tissues?  what  docs  it  signify 
whether  it  be  their  mucous  membrane,  their  glands,  or  their  Interstitial  sub- 
stance? Should  the  patient's  general  health  improve  under  your  treatment, 
he  will  naturally  live  as  long  as  it  continues  to  do  so:  if  not,  and  if  it  .••■ 

ainueto  get  worse,  he  must  diel  Any  further  discussion  oftho 
matter,  quoad  hoc,  resolves  itself  into  the  interminable  question  of  Tweedle- 
dum  and  Twecdlc-t/cc  / 


LECTURE  III.  65 

"  Can  consumption  be  cured  ?"  asked  Mr.  Abemethy,  adding  in  his  own 
sarcastic  manner,  "  Odd  bless  me  !  that's  a  question  which  a  man  who  lived 
in  a  dissecting-room  would  laugh  at.  How  many  people  do  you  examine  who 
have  lungs  tubercular  which  are  otherwise  sound  ?  What  is  Consumption  ? 
It  is  tubercle  of  the  lungs  ;  then  if  those  tubercles  were  healed,  and  the  lungs 
otherwise  sound,  the  patient  must  get  better  ;  but  if  the  inquirer  shift  his 
ground,  and  say,  '  It  was  the  case  I  meant  of  tubercles  over  the  whole  lungs,' 
why  then,  he  shifts  his  ground  to  no  purpose,  for  there  is  no  case  of  any 
disease  which,  when  it  has  proceeded  to  a  certain  extent,  can  be  cured." 

The  next  question  is,  what  are  tubercles  ?  I  take  this  to  be  the  true 
answer  : — For  the  requisite  lubrication  of  the  mucous  membrane  of  the  cells, 
and  other  air-passages  of  the  lungs,  there  must  be  a  certain  amount  of  secre- 
tion. To  supply  this  secretion,  I  need  not  tell  you,  there  must  be  a  glandular 
apparatus.  A  number  of  minute  and  almost  imperceptible  Glands,  accord- 
ingly, do  intersperse  the  entire  tissue  of  the  lungs — the  pulmonary  tissue,  as 
it  is  called — and  abound  more  particularly  in  the  upper  portion  of  it — that 
identical  portion  in  which  pathologists  imagine  they  have  detected  the  com- 
mencement of  consumption.  But  what  they  call  the  commencement  is  nothing 
more  than  an  effect  or  development  of  general  constitutional  disorder.  If 
it  be  the  beginning,  it  is  the  beginning  of  the  end — the  end  of  previous 
repeated  febrile  paroxysms  of  greater  or  lesser  intensity.  During  such  con- 
stitutional disorder,  and  particularly  during  the  course  of  severe  fevers — such 
as  a  long  remittent  fever,  the  fevers  termed  small-pox,  measles,  and  the  like 
— these  minute  pulmonary  glands  become  diseased,  there  being  a  previous 
predisposition  of  course  ;  in  other  words,  these  glands  being  the  original  weak 
point  of  individuals  having  the  consumptive  tendency.  Tubercles,  then,  are 
diseased  pulmonary  glands.  How  many  people  have  traced  the  consumption 
of  their  children  to  the  small-pox  or  measles ;  but  would  any  man  in  his 
senses  say  the  consumption  was  the  cause  of  these  fevers  ?  Here  it 
must  have  been  the  effect,  and  so  also  it  may  be  the  effect  of  any  other 
kind  of  Fever,  and  in  no  case  can  it  be  the  cause  of  such  fever — though, 
as  in  the  giving  way  of  any  other  part  of  the  body,  the  local  disease  may  in 
the  course  of  time  aggravate  and  keep  up  the  febrile  state.  The  affected 
gland  is  in  this  instance  at  first  almost  microscopically  minute ;  but  as  the 
disease  advances,  it  swells  and  becomes  of  a  reddish  grey  colour,  or  it  may 
at  once  take  on  a  suppurative  action — it  may  become  an  abscess  varying  from 
the  size  of  a  pea  or  less  to  that  of  a  walnut  or  more  ;  or  it  may  go  on  enlarg- 
ing to  any  extent  without  suppuration  or  becoming  an  abscess  at  all ;  the 
function  of  the  affected  lung  in  this  case  being,  nevertheless,  as  completely 
disturbed  as  if  it  did  take  on  the  suppurative  state ;  but  in  most  cases  of  con- 
sumptive disease,  both  kinds  of  disorganization  go  on  at  the  same  time,  one 
gland  or  cluster  of  glands  suppurating,  and  sooner  or  later  bursting  and  dis- 
charging their  contents  into  the  air-passages,  rendering  the  lungs  at  the  same 
time  more  or  less  cavernous  and  hollow  ;  another  gland  or  cluster  of  glands 
swelling  and  coalescing  so  as  to  fill  up  and  solidify  the  air-cells  of  the  part 
they  occupy.  These  at  least  are  among  the  principal  changes  to  be  found 
in  the  lungs  of  persons  who  die  of  consumption  ;  and  they  are  all,  as  I  have 
already  stated,  more  or  less  gradually  produced  in  the  course  of  repeated 
paroxysms  of  general  remittent  disorder.  The  matter  expectorated  by  the 
patient  consists  of  the  contents  of  the  tuberculous  abscess,  and  more  or  less 
mucus,  sometimes  mixed  with  blood  ;  while  the  cough  may  be  either  pro- 
duced by  a  lodgment  of  matter  in  the  air-passages,  or  be  a  spasmodic  effect 
of  the  cold  air  coming  in  contact  with  the  ulcerated  surface  of  the  diseased 
lungs  ;  almost  every  patient,  however,  has  it  periodically  more  or  less  severe. 
To  understand  this  subject  in  all  its  bearings,  you  have  only  to  observe  the 
more  palpable  changes  which  take  place  in  the  glands  of  the  Neck  of  certain 
patients.  These  glands,  in  the  healthy  living  subject,  can  neither  be  seen  or 
felt ;  but  apply  any  general  influence  that  shall  excite  Fever  in  an  individual 


66  LECTURE  III. 

predisposed  to  glandular  disorder — such  as  starvation,  exposure  to  cold,  or  the 
abuse  of  mercury — and  what  do  you  find  1  Why,  these  very  glands  gradu- 
ally enlarge  and  form  tumours  ;  which  tumours,  as  in  the  case  of  tubercles  of 
the  lungs,  are  sometimes  of  a  solid  kind,  and  when  examined  after  death,  have 
the  same  reddish-grey  appearance,  but  more  frequently  like  them  terminate 
in  abscesses,  the  contents  of  which,  so  far  as  mere  likeness  is  concerned,  are 
the  identical  contents  of  pulmonary  tubercles,  or  "  Vomica?,"  as  these  tuber- 
cles are  sometimes  called.  In  the  one  case,  the  patient  is  said  to  have  the 
"  Evil"  or  Scrofula,  in  the  other  Phthisis  or  Consumption  ;  the  diilerence  of 
place,  and  the  degree  of  importance  of  this  in  the  animal  economy,  making 
the  only  difference  between  them.  In  still  farther  proof  of  the  correctness  of 
this  explanation,  I  may  mention,  that  Louis  and  others  have  detected  tuber- 
culous matter  in  various  other  Glandular  parts  of  the  bodies  of  patients  who 
have  died  consumptive.  If  it  be  objected  that  they  have  also  detected  it  in 
the  Bones,  I  answer,  the  bones,  like  every  other  part,  have  a  glandular  appa- 
ratus ;  and  this  more  particularly  in  the  neighbourhood  of  their  cartilaginous 
or  secretive  surfaces — the  joints.  In  the  joints,  accordingly,  we  often  find 
tuberculous  matter  developed.  The  shafts  of  bones,  having  fewer  glands, 
are  seldom  affected  with  tuberculous  disease. 

We  now  come  to  the  question  of  cure ;  and  from  what  we  have  already 
said,  you  must  be  aware,  that  however  curable  pulmonary  consumption  may 
he  in  the  commencement — in  the  later  stages — that  is,  where  a  very  consider- 
able portion  of  the  lungs  is  destroyed- — it  cannot  possibly  be  cured,  though 
even  in  this  case,  the  disease,  by  proper  management,  may  sometimes  be 
arrested.  But  here,  instead  of  confusing  you  with  fine-spun  differences  and 
distinctions,  the  delight  of  the  schoolmen,  I  shall  try  to  explain  mv  meaning 
to  you  by  similitudes  ;  for  similitudes,  in  the  words  of  Fuller,  are  indeed 
"the  windows  that  give  the  best  light.'"  Some  of  you,  doubtless,  have  had 
a  certain  portion  of  tooth  slowly  consumed  by  disease,  which  disease  (tooth- 
consumption  ?)  by  some  change  in  your  manner  of  living,  or  otherwise,  has  all 
of  a  sadden  stopped,  and  the  remaining  sound  portion  of  that  identical  tooth 
has  continued  to  be  useful  to  you  for  years  !  Such  arrest  of  the  consumption 
of  a  tooth,  I  have  often  myself  obtained  by  quinine  internally  administered  ; 
and  Dr.  Irving,  of  Cheltenham,  some  time  ago,  detailed  to  me  two  cases  in 
which  he  succeeded  with  that  remedy.  Well,  then,  with  medicines  of  this 
class,  and  sometimes  even  without  any  medicine  at  all,  the  same  thing  may 
take  place  in  the  lungs  ;  and  I  have  known  persons  reach  a  good  old  an;e,  who 
had  portions  of  their  lungs  destroyed,  but  who,  by  proper  medicine,  and  atten- 
tion to  the  temperature  of  their  chambers,  preserved  the  sound  parts  from 
going  into  further  decay.  Such  persons,  at  greater  or  less  intervals  of  time, 
may  even  be  free  from  the  graver  symptoms  of  consumption,  and  only  com- 
mence to  expectorate  during  some  change  of  weather — when  they  have 
slight  febrile  attacks ;  but  these  will  leave  them  again  on  the  return  of  warm 
weather. 

But  Consumption,  in  many  instances,  is  curable — curable  in  stages  even 
considerably  advanced.  The  reparative  power  inherent  in  a  liviu -  body  is 
so  great,  that  if  you  break  the  bone  of  your  leg  or  arm,  nature,  without  any 
physic  at  all,  will  reunite  the  broken  parts—  provided  the  system  be  kept  free 
from  fever,  and  nature  will  repair  the  broken  lung  as  surely  as  it  will  cure  the 
broken  leg.  Oh  !  but,  say  the  men  who  decide  this  question  in  the  negative 
— how  can  that  be,  seeing  the  lungs  are  always  in  motion  ? — that  of  itself 
would  prevent  such  a  desirable  end.  That  of  itself,  Gentlemen,  would  do  no 
such  thing.  Many  and  many  persons  have  had  a  small  sword  or  a  pistol-ball 
passed  through  their  breast,  so  that  it  has  come  out  again  at  the  back,  and  have 
yet  perfectly  recovered.  Perhaps  the  Luog  in  such  cases  was  not  wounded  ? 
So  I  have  heard  people  6ay ;  but  my  answer  was  ready.  The  pat  ent  spit 
blood  immediately  on  the  receipt  of  his  wound  !  That,  I  fancy,  you  (rill  call 
pretty  conclusive  evidence  of  the  lungs  being  wounded.      Well,  then, 


LECTURE  III.  67 

so  wounded  have  recovered,  though  all  the  time  their  lungs  were  in  motion. 
Cure  the  consumptive  fever,  I  repeat,  and  the  lun«s  will  cure  themselves  as 
certainly  as  any  other  injured  parts  of  the  body.  Those  who  deny  the  cura- 
bility of  consumption  are  generally  ignorant,  conceited  creatures,  who  know 
nothing  but  what  they  have  picked  up  in  books,  or  in  the  dissecting-room — 
they  argue  of  the  beginning  from  what  they  have  seen  of  the  end — of  the  liv- 
ing from  their  dissections  of  the  dead. 

The  same  power  that  may  set 'a  ship  on  the  right  course,  improperly  ap- 
plied will  set  it  on  the  wrong.  This  is  exactly  the  case  with  medicine  ;  the 
same  power  that  has  cured  a  disease  in  one  person,  may  cause  or  aggravate  it, 
according  to  circumstances,  in  another.  How  frightful,  then,  that  such  powers 
should  be  daily  wielded  by  men  who  have  not  the  smallest  idea  of  the  prin- 
ciple upon  which  their  remedies  act !  No  wonder  we  have  such  contrary 
estimates  of  the  value  of  remedies  in  pulmonary  consumption.  A  case  of 
this  disease,  which  was  cared,  I  will  now  read ;  it  is  from  the  pen  of  the 
patient,  himself  a  physician — the  late  Dr.  Currie,  of  Liverpool,  who  wrote 
the  life  of  Burns  ;  and  it  is  given  by  Dr.  Darwin  in  his  Zoonomia.  "  J.  C, 
aged  27,  with  black  hair  and  a  ruddy  complexion,  was  subject  to  cough  from 
the  age  of  puberty,  and  occasionally  to  spitting  of  blood  ;  his  maternal  grand- 
father t'ied  of  consumption  under  thirty  years  of  age,  and  his  mother  fell  a 
victim  to  this  disease,  with  which  she  had  been  long  threatened,  in  her  43rd 
year,  and  immediately  after  she. had  ceased  to  have  children.  In  the  severe 
winter  of  1773-4,  he  was  much  afflicted  with  cough,  and  bein£  exposed  to 
intense  cold  in  the  month  of  February,  he  was  seized  with  Peripncumony, 
[inflammation  of  the  lungs,  now  called  Pneumonia].  The  disease  was  violent 
and  dangerous,  and  after  repeated  bleedings,  as  well  as  blisterings,  which  he 
supported  with  difficulty,  in  about  six  weeks  he  was  able  to  leave  his  bed. 
At  this  time  the  cough  was  severe,  and  the  expectoration  difficult ;  a  fixed 
pain  remained  in  the  left  side,  where  an  issue  was  inserted.  Regular  hectic 
{habitual  or  wasting  fever)  came  on  every  day,  about  an  hour  after  noon, 
and  every  night  heat  and  restlessness  took  place,  succeeded  towards  morning 
by  general  perspiration.  The  patient,  having  formerly  been  subject  to  Ague, 
was  struck  with  the  resemblance  of  the  febrile  paroxysms,  to  what  he  had 
experienced  under  that  disease,  and  was  willing  to  flatter  himself  it  might  be 
of  the  same  nature  :  therefore  he  took  bark  in  the  interval  of  the  fever,  but 
with  an  increase  of  his  cough."  This  patient  eventually  recovered  b}'  change 
of  air  and  horse- exercise — the  last,  a  remedy  held  in  high  repute  by  Syden- 
ham. What  first  induced  Sydenham  to  prescribe  horse-exercise  for  pulmon- 
ary consumption  ?  Was  it  any  knowledge  he  had  obtained  in  the  dissecting- 
room  ?  No  such  tiling  ;  it  was  the  same  kind  of  experience  that  first  taught 
the  Peruvian  peasant  the  value  of  bark  as  a  remedy  for  ague  ;  the  observa- 
tion of  its  good  eflects  upon  the  living.  You  might  dissect  dead  bodies  all 
your  life,  without  ever  once  guessing  that  either  the  one  agency  or  the  other 
could  beneficially  influence  any  kind  of  disorder.  See,  then,  "the  difference 
betwixt  watching  the  action  of  external  influences  on  living  bodies,  and  dis- 
secting and  hair-splitting  the  broken-down  organs  of  dead  ones  !  "  What- 
ever phiiosopher  or  projector,"  says  Dean  Swift  in  his  Tale  of  a  Tub,  "  can 
find  out  an  art  to  solder  and  patch  up  the  flaw  and  imperfections  of  nature, 
will  deserve  much  better  of  mankind,  and  teach  us  a  more  useful  science  than 
that  so  much  in  present  esteem,  of  widening  and  exposing  them — like  him 
who  held  anatomy  to  be  the  ultimate  end  of  physic."  Persons  of  this  stamp, 
we  have  seen,  are  not  yet  extinct. 

The  relationship  existing  between  consumption  and  ague  is  not  only  estab- 
lished by  the  remissions  and  exacerbations  of  the  above  case,  but  also  by  the 
remedies  that  proved  successful  in  its  treatment;  horse-exercise  and  change  of 
air  having  cured  agues,  which  had  resisted  every  kind  of  internal  treat- 
ment, bark  among  the  number ;  so  that  bark  is  no  more  a  specific  for  ague, 
than    for   any   other  disease.       When   you   judge  solely  from    the  expe- 


68  LECTURE  III. 

rieuce  of  the  case  I  have  just  read,  in  which  the  bark  not  only  failed,  bat 
actually  aggravated  the  symptoms,  you  might  be  led  to  conclude,  "that  it  ought 
never  to  be  exhibited  in  consumption;  but  you  will  please  to  remember  that 
the  same  is  every  day  the  effect  of  its  employment  in  ague — in  which  latter 
disease  we  therefore  dismiss  it  for  arsenic,  opium,  iron,  or  some  other  chrono- 
thermal  agent,  which  may  better  answer  the  peculiar  habit  of  the  patient,  and 
which  we  cannot  know  till  we  try.  Never,  like  weak-minded  persons,  take 
your  estimation  of  any  medicines  or  system  of  medicine  from  its  success  or 
failure  in  one  or  two  cases. 

In  the  13th  volume  of  the  Medical  Gazette,  you  will  find  the  detailed  case 
of  a  man  labouring  under  consumption  ;  for  whom  Mr.  Maclure,  the  gentle- 
man who  narrates  it,  prescribed  generous  diet  and  quinine.  Dr.  Marshall 
Hall  examined  the  patient  with  the  stethoscope,  and  pronounced  an  unfavour- 
able prognostic.  Even  after  commencing  the  quinine,  and  when  a  considerable 
improvement  had  taken  place  in  the  appearance  of  the  patient,  Dr.  Hall  still 
held  that  the  case  would  be  fatal;  "  again  the  stethoscope  was  consulted — 
again  it  uttered  the  same  sepulchral  responses  ;  and  according  to  it,  the  poor 
patient  ought  by  this  to  have  been  moribund,  his  pulse,  good  looks,  muscular 
firmness,  appetite,  and  his  high  spirits,  notwithstanding.  I  need  hardly  add," 
says  the  narrator  of  this  case,  "  that  your  judicious  friend,  the  doctor,  was 
much  surprised,  as  well  as  gratified,  to  witness  his  appearance" — alluding  to 
the  change  after  the  cure  had  taken  place.  .  Justice  to  Dr.  Marshall  Hall 
compels  us  to  say,  that  he  was  anything  but  gratified  with  this  result ;  for  in 
another  number  of  the  same  journal,  not  only  does  he  speak  daggers  at  Mr. 
Maclure  for  publishing  the  case  ;  but  he  goes  into  a  very  learned  discussion 
.as  to  whether  the  cessation  of  symptoms  were  not  a  Suspension  rather  than 
a  Cure.  For  our  present  purpose,  it  is  quite  enough  that  he  admits  suspen- 
sion ;  and  if  this  suspension  continued  for  a  series  of  years,  it  is  scarcely 
worth  while  inquiring  whether  the  patient  was  cured  or  not.  In  fact,  the 
matter  would  resolve  itself  into  a  mere  dispute  about  words. 

By  emetics  frequently  repeated,  and  alternated  with  chrono-thermal  medi- 
cines, I  am  satisfied  I  have  cured  or  arrested  many  cases  of  consumption — 
some  of  them,  too,  in  apparently  very  advanced  stages.  The  stethoscopist 
will,  of  course,  question  this,  and  ask  how  I  could  know,  without  using  their 
instrument.  I  shall,  therefore,  give  you  a  case  of  this  kind  in  which  it  was 
employed,  not  by  myself,  but  by  men  who  have  the  reputation  at  least  of 
being  wonderfully  quick  in  the  use  of  it : — A  pianoforte-maker,  aged  36,  came 
to  me  much  emaciated  :  he  complained  of  shiverings,  chills,  and  heats,  night 
sweats,  cough,  and  expectoration  of  matter,  tinged  with  blood  occasionally  ;  he 
informed  me  that  he  had  been  a  patient  at  a  provincial  dispensary,  from  which, 
after  having  for  some  months  taken  much  medicine,  and  been  repeatedly 
blistered,  he  was  discharged  as  incurable.  The  stethoscope,  he  informed 
me,  had  been  consulted  in  his  case  by  Drs.  M.  and  A.  both  of  vhom  told  his 
wife  he  was  in  the  last  stage  of  consumption,  and  there  was  no  hope.  I  pre- 
scribed hydrocyanic  acid  three  times  a-day,  and  ordered  him  to  take  a  pill, 
containing  a  combination  of  opium  and  quinine,  at  that  period  of  the  day 
when  he  should  find  himself  most  free  from  the  symptoms  of  his  disease. 
From  that  day  he  began  to  recover  his  flesh  and  spirits  ;  his  pulse,  which  was 
120,  gradually  fell  to  80  ;  his  appetite  improved  daily  :  his  expectoration  dimin- 
ished in  proportion;  and  in  about  three  months  he  returned  to  his  work,  with- 
out any  complaint  whatever.  I  must  not  omit  to  add,  that  I  ordered  him  to 
apply  a  galbanum  plaster  to  his  spine,  in  which  he  had  suffered  from  chills, 
and  these  it  effectually  stopped.  A  year  afterwards,  1  saw  him  nuain  ;  when, 
in  the  presence  of  Dr.  Sclwyn,  of  Ledbury,  he  told  me  he  was  quite  well, 
and  was  still  at  his  work,  and  he  expressed  to  me  his  gratitude  for  my  sur- 
<■<  ifn]  efforts  in  his  favour.  Now  some  will  say  due  was  consumption,  and 
some  not— -for  when  die  patient  dies,  nobody  disputes  it ;  but  when  I 
well,  every  body  does ;  some  again  may  say  that  the  disease  might  break  out 


LECTURE  III.  69 

again  at  some  future  period,  say  five  or  six  years  after,  which  I  am  ready  to 
grant ;  and  what  is  more,  to  admit,  may  happen  after  a  cure  in  any  disease 
whatever  :  and  so  may  a  fractured  bone  that  has  united  and  been  cured  in  the 
best  possible  manner,  become,  in  the  course  of  years  and  constitutional  change, 
disunited  again — as  you  may  find,  if  you  will  read  the  acccount  of  the  diseases 
of  the  sailors  who  accompanied  Lord  Anson  in  his  voyages. 

A  maid-servant,  25  years  of  age,  the  subject  of  consumption,  had  been  an 
out-patient  at  the  same  dispensary  for  several  months,  during  which  she  had 
been  bled,  leeched,  and  blistered,  but  as  she  found  herself  daily  getting  worse, 
she  came  to  me;  she  was  then  spitting  blood  and  muco-purulent  matter  ;  her 
pulse  was  quick  and  small ;  she  had  chills  and  heats,  and  night  sweats,  with 
severe  cough.  I  prescribed  hydrocyanic  acid,  as  in  the  above  case,  with 
opium  and  quinine  during  the  remission  ;  with  this  treatment  she  recovered 
completely,  and  though  several  years  have  now  elapsed,  she  has  had  no  re- 
turn of  her  disease. 

When  I  first  entered  into  private  practice  in  this  country,  I  was  much 
abused  for  giving  prussic  acid,  and  that,  too,  by  individuals  who  afterwards 
ordered  it  in  their  own  prescriptions  !  "  We  old  practitioners,"  I  have  been 
told  by  some  of  these  very  enlightened  persons,  "  don't  like  your  iodine — your 
prussic  acid — your  creosote — and  your  new  medicines.  We  have  known 
injury  to  follow  their  use."  And  what  remedy  in  the  world  in  the  hands  ot 
blockheads  may  not  do  the  same  1  Iodine,  prussic  acid,  and  the  new  medi- 
cines, are  only  valuable  in  the  hands  of  those  who  know  the  principle  of  their 
application ;  like  fire  or  hot  water,  they  are  not  to  be  left  at  the  mercy 
of  fools  or  children ;  inasmuch  as,  like  either  of  these  agents,  they  may 
warm  you  in  one  degree,  and  destroy  you  in  another.  Moreover,  they 
will  not  agree  with  all  patients  in  any  dose  ;  but  who  they  are  to  agree  with, 
you  cannot,  of  course,  know  till  you  try ;  and,  therefore,  you  will  suit  your 
patient's  constitution  as  best  you  can  ;  for,  in  the  words  of  Lord  Bacon,  "  a 
wise  physician  doth  not  continue  still  the  same  medicine  to  a  patient,  but  he 
will  vary,  if  the  first  medicine  doth  not  apparently  succeed  ;  for  of  those  re- 
medies that  are  good  for  the  jaundice,  stone,  agues,  &c,  that  will  do  good  in 
one  body  which  will  not  do  good  in  another — according  to  the  correspondence 
the  medicine  hath  to  the  individual  body."  Is  not  this  matter  of  every  day's 
experience  ?  How  can  we  tell  before  we  try,  whether  opium  will  set  a 
person  to  sleep,  or  keep  him  awake  all  night  ?  or  that  prussic  acid  will 
aggravate  consumption  in  one  case,  and  cure  or  ameliorate  it  in  another  ? 
Gentlemen,  I  shall  afterwards  prove  that  the  reason  of  the  difference  of  effect 
of  all  remedies,  is  the  difference  of  the  electric  condition  of  the  brain  of  differ 
ent  patients.  But  whatever  be  the  true  explanation  of  the  facts,  they  show, 
at  least,  the  utter  impossiblity  of  foretelling,  in  numerous  cases,  by  what  re- 
medial agency  you  can  accomplish  a  given  object — and  they  must  also  demon 
strate  to  all  who  have  even  the  very  least  pretension  to  common  sense,  the 
imposture  daily  practised  by  the  charlatan,  when  he  puffs  his  nostrum  as  a 
universal  and  infallible  remedy.  But  so  fur  as  regards  prussic  acid,  its  good 
effects  in  numerous  cases  of  consumption  are  unquestionable.  On  the  Con- 
tinent, Magendie,  among  others,  "  asserts  and  maintains,"  that  with  this  acid 
he  has  cured  individuals,  "  having  all  the  symptoms  of  incipient  phthisis 
(consumption),  and  even  those  in  a  more  advanced  stage."  Dr.  Frisch,  of 
Nyborg,  in  Denmark,  has  also  employed  the  remedy  successfully  in  con- 
sumption. But  prussic  acid  is  equally  influential  as  a  remedy  for  Ague,  and 
I  have  administered  it  with  the  most  perfect  success  in  cases  of  that  disease, 
after  they  had  resisted  quinine  and  arsenic.  Dr.  Brown  Langrish,  too,  with 
laurel-water  (the  virtues  of  which  depend  upon  the  prussic  acid  it  contains,) 
cured  many  cases  of  obstinate  ague.  The  principle  upon  which  this  acid 
acts  in  both  diseases,  I  need  not  say,  is  one  and  the  same  ;  namely,  by  its 
power  Electrically  to  influence  the  motion  and  temperature  of  certain  parts 
of  the  body,  through  the  medium  of  the  brain  and  nerves.     People  who  have 


70  LECTURE  III. 

accidentally  taken  an  over-dose,  will  tell  you  how  they  felt  as  if  they  had 
had  an  electric  shock.  Whatever  producer  a  sudden  impression  upon  the 
whole  frame  causes  such  shock.  Whatever  acts  upon  it  more  slowly  does 
the  same  in  effect  as  galvanism  or  electricity  slowly  and  gradually  applied. 
How  otherwise  can  you  influence  the  body  in  disease — 

With  drugrs  or  minerals 

That  waken  motion  ! — Shakspeare. 

The  action  of  such  substances,  I  need  not  tell  yon,  is  anything  but  mechanical. 
What,  then,  can  it  be  but  electrical  or  galvanic  ?  To  call  it  chemical  or  mag- 
netic is  only  an  admission  of  my  position  ;  for  these  have  been  proved  by  Mr. 
Faraday  to  be  mere  modification.;  of  the  same  great  principle.  We  can  now 
understand  how  galvanism  and  electricity  may  be  directly  and  advantageously 
employed  in  every  disease  which  has  obtained  a  name,  ague  and  consump- 
tion among  the  number. 

But  there  is  another  mode  of  influencing  consumption,  which  it  would  be 
well  for  the  patient  were  it  more  frequently  resorted  to;  namely,  the  em- 
ployment of  cold  shower  and  plunge  baths.  In  the  case  of  a  gentleman  whom 
I  saw  some  time  ago,  with  Dr.  Watson  of  the  Middlesex  Hospital,  I  stopped 
the  shivering  fits  at  once  by  the  employment  of  the  coZJ-shower  bath,  after  a 
hot  bath  and  a  warm  plaster  to  the  spine  had  been  tried  in  vain.  The  gentle- 
man who  was  the  subject  of  it  was  otherwise  much  improved.  His  friends, 
however,  persuaded  him  he  could  not  live  the  winter  in  England,  so  he  went 
to  Madeira  and  died.  But  in  another  case,  which  I  also  saw  with  Dr.  Wat- 
son, and  which  I  shall  now  detail  to  you,  a  perfect  cure  was  obtained.  Mr. 
L ,  an  artist  of  eminence,  aged  60,  was  suddenly  taken  with  a  very  malig- 
nant Fever,  in  the  course  of  which  every  organ  of  his  body  was  more  or 
less  painfully  affected  ;  he  had  a  fearful  cough,  with  severe  pain  in  the  chest, 
side,  and  back,  and  he  expectorated  (with  much  difficulty)  a  tough  mucus, 
which  every  moment  threatened  to  suffocate  him.  His  pulse  was  very  quick, 
and  sometimes  remittent,  and  his  skin  became  jaundiced  all  over ;  his  urine, 
at  the  same  time,  being  almost  black.  For  some  days  he  was  in  the  most 
imminent  danger;  but  by  chrono-thermal  treatment,  and  without  the  loss  of 
a  drop  of  blood,  the  severer  symptoms  began  to  give  way,  the  fever  dimin- 
ished in  intensity,  and  the  pulse  came  down  to  80.  The  hopes  of  his  friends 
were  now  high,  when  suddenly  one  morning  he  expectorated  muco-purulent 
matter,  having  exactly  the  appearance  of  what  consumptive  people  cough  up. 
His  fever  now  returned — his  pulse  rose  to  140 — he  was  harassed  by  cough, 
and  every  day  from  that  time  he  expectorated  at  least  half  a  pint  of  muco- 
purulent matter.  I  had  now  little  hope  of  saving  this  gentleman's  life.  How- 
ever, by  steady  perseverance — and  in  the  right  course  what  will  not  perse- 
verance do  ? — by  steady  perseverance,  I  say,  in  the  use  of  quinine,  copaiba, 
and  other  medicines  which  I  prescribed  for  him,  together  with  the  cold 
shower-bath,  and  (when  he  could  bear  to  be  removed)  with  country  air  and 
horse  exercise,  in  somewhere  about  six  months  his  health  gradually  became 
re-established  ;  the  cough  and  expectoration,  at  the  same  time,  kept  diminish- 
ing, until  it  finally  ceased  altogether.  For  the  last  two  years  and  moie,  I  am 
happy  to  say,  this  patient  has  not  had  a  single  consumptive  symptom — his 
general  health  also  is  now  as  good  as  it  ever  was  in  his  life. 

1'.'  lure  I  quit  the  subject  of  consumption,  I  may  mention  that,  in  many 
cases  of  the  disease,  I  have  derived  great  benefit  from  arsenic  and  silver,  and 
also  from  the  sub-carbonate  of  potass.  In  four  or  five  cases,  which  r 
many  remedies,  a  combination  of  stramonium  and  belladonna  arrested  for  a 
time,  though  it  did  not  ultimately  cure,  the  complaint.  In  many  cases  about 
which  we  are  consulted,  the  disease  may  have  proceeded  so  far  as  to  make 
cure  impossible  ;  in  other  cases,  which  might  seem  to  admit  of  this  desirable 
end,  circumstances  over  which  we  have  no  control,  will  prevent  it.  Do  vmi 
think  it  possible  to  cure  a  person  of  any  grave  disease,  if  he  u  i  i 
ingly  on   the   eve  of  bankruptcy,  or  who  lived  in  an  'atmosphere  which  dis- 


LECTURE  III.  71 

agreed  with  his  health  generally,  or  who  had  a  wife  continually  scolding 
him,  and  making  him  miserable  ?  In  such  cases,  need  I  say,  it  will  be  diffi- 
cult to  give  even  temporary  benefit  to  a  consumptive  patient. 

There  is  a  phrase  at  present  so  much  in  fashion,  that  were  I  all  at  once  to 
tell  you  it  was  absolute  and  indisputable  nonsense,you  would,  in  all  probability, 
stare  with  astonishment.  Gentlemen,  did  any  of  you  ever  hear  of  Uram-cough, 
or  .Ear-cough,  or  Eye-cough.  ?  No !  But  you  have,  of  course,  heard  two 
doctors  discussing  with  the  greatest  gravity  imaginable,  whether  a  particular 
complaint  was  incipient  consumption  or  "  Stomach-cough ;"  as  if  people  in 
these  days  coughed  with  their  stomachs  instead  of  their  lungs  !  Only  let  a 
fashionable  physician  give  currency  to  this  kind  of  false  coin,  and  it  will  pass 
for  genuine,  till  some  suspicious  character  like  himself  shall  submit  it  to  ana- 
lysis at  the  mint  of  Common  Sense — and  then — what  then?  Why  people 
will  scarcely  even  then  believe  the  evidence  of  the  whole  of  their  five  senses 
put  together  ;  for,  as  some  one  says,  when  the  gullible  public  once  get  hold 
of  a  lie,  they  become  so  enamoured  of  it,  that  nothing  but  death  will  make 
them  part  with  it.  Who  first  introduced  the  phrase  "  stomach-cough,"  I  do 
not  know ;  but  Dr.  Wilson  Philip,  at  all  events,  insists  that  "  indigestion  or 
dyspepsia"  is  the  remote  cause  of  a  variety  of  consumption  ;  and  in  proof  of 
this,  he  tells  us  he  has  cured  it  with  minute  doses  of  mercury.  Now,  if  that 
were  any  proof  of  the  origin  of  a  disease,  every  disease  in  existence  might  be 
termed  a  "  stomach  affection  ;"  for  I  know  very  few  chronic  complaints,  how- 
ever grave,  which  I  have  not  myself  cured  by  the  same  medicine  ;  ay,  and 
have  seen  aggravated  by  it  too.  In  the  latter  case,  of  course,  the  complaint 
could  not  be  a  "  stomach  disease."  Direct  your  attention,  says  Dr.  Philip, 
to  the  digestive  organs,  and  you  will  improve  the  subject  of  "  dyspeptic 
phthisis."  And  so  you  may,  if  you  direct  your  attention  to  any  other  part 
of  the  body  of  a  consumptive  patient — for  what  part  of  the  body  of  such  a 
patient  performs  its  functions  correctly  1  In  this  disease,  the  feet  and  hands 
feel  cold  and  hot  by  turns,  the  skin  one  moment  harsh  and  dry,  is  at  another 
bedewed  by  a  cold  and  clammy  sweat.  Are  these  causes  or  coincidents  ?— 
May  you  not  as  well  say,  Cure  the  consumption,  and  the  digestive  powers 
will  improve,  as,  Cure  the  indigestion,  and  you  will  stop  the  consumption  ? 
Medical  men  constantly  talk  of  indigestion  as  an  essence  or  entity,  having 
features  separate  and  distinct  from  all  other  disorders.  Can  any  person,  I 
ask,  be  the  subject  of  any  disease  without  his  digestion  being  more  or  less 
implicated  ?  What  becomes  of  your  digestion  in  Fever?  or  when  you  get 
bad  news  just  as  you  are  about  to  eat  your  dinner  ?  Though  you  were  as 
hungry  as  a  hawk  a  moment  before,  your  appetite  would  leave  you  then. — 
Gentlemen,  have  we  a  brain,  or  have  we  not  ?  Give  a  man  a  blow  on  that, 
and  see  what  becomes  of  his  digestion  !  How  much  the  workings  of  this 
organ  have  to  do  with  the  functions  of  the  stomach,  we  have  a  lesson  in  the 
play  of  Henry  VIII.  Mark  what  the  fiery  monarch  says  to  Cardinal  Wol- 
sey,  when  surprising  him  with  the  proofs  of  his  treachery — 

Read  o'er  this, 

And  after,  this ;  and  then  to  breakfast 
With  what  appetite  you  have. 

Do  you  doubt  that  the  breathing  of  a  man  thus  suddenly  and  unceremo- 
niously surprised,  would  be  as  much  affected  at  such  a  moment  as  his  appe- 
tite ?  See  then  the  absurdity  of  placing  naturally  coincident  circumstances 
in  the  light  of  cause  and  effect !  Shakspeare  knew  the  influence  of  a  passion 
upon  the  totality  of  the  body  better  than  half  the  faculty,  and  I  am  not  sure 
that  he  could  not  have  prescribed  to  better  purpose  than  them  all  put 
together.  Do  you  think  in  cases  of  this  kind  he  would  have  troubled  his 
head  about  the  digestive  organs,  or  that  he  would  have  said,  like  many  of 
the  great  doctors  of  the  day,  "  we  must  put  the  stomach  and  bowels  to  rights  !" 
Certainly  not ;  he  would  have  made  the  Brain  his  first  care  ;  he  would  have 
first  tried  to  soothe  and  comfort  that,  and  then  he  would  have  expected  the 


72  LECTURE  III. 

appetite  to  return.  Now,  that  is  what  ought  to  be  done  in  all  complaints, 
indigestion  and  consumption  included.  Every  organ  of  the  body  is  of  importance 
in  our  economy, — but  the  Brain  is  so  important  an  organ  that  people  cannot  live 
a  moment  without  it;  and  whatever  affects  it,  for  good  or  for  evil,  equally,  for 
good  or  for  evil,  affects  every  other  part  of  the  body, — the  lungs  as  much  as  the 
stomach.  Through  the  medium  of  the  Brain  and  nerves  only,  can  mercury  or 
any  other  medicine  influence  the  diseases  of  these  two  last-mentioned  organs, 
whether  advantageously  or  the  reverse ;  and,  as  I  have  already  told  you, 
mercury  can  do  both, — according  to  the  correspondence  and  fitness  it  hath  for 
individual  bodies,  and  the  scale  or  degree  in  which  it  may  be  administered. 
But  upon  the  subject  of  appetite  the  greatest  nonsense  prevails,  even  in  the 
profession.  Tou  hear  that  such  a  one  is  ill — very  ill, — but,  thank  Heaven  ! 
his  appetite  still  keeps  "  good."  How,  then,  is  it  that  the  patient  continues 
day  by  day  to  waste  and  become  skeleton-like  ?  It  is  because  that  man's 
appetite,  so  far  from  being  "  good — nay,  excellent,"  is  morbidly  voracious  and 
craving,  having  as  much  resemblance  to  the  appetite  of  health  as  the  diabetic 
flow  ot  urine  has  to  a  useful — that  is,  a  moderate — secretion  from  the  kidneys. 
No  man  can  possibly  be  the  subject  of  disease  of  any  kind  without  his  diges- 
tive organs  partaking  in  the  general  totality  of  derangement.  Whatever  can 
improve  the  general  health  in  one  case,  may  do  the  same  in  the  other.  Now, 
though  the  chrono-thermal  remedies,  judiciously  administered  during  the 
remission,  may  of  themselves  singly  cure  almost  every  kind  of  disease, — yet 
it  is  my  custom  to  combine  and  alternate  them,  as  I  have  already  said,  with 
such  medicines  as  experience  proves  have  more  or  less  affinity  to  the  particu- 
lar parts  of  the  body  most  implicated  in  a  given  case, — mercury,  iodine,  and 
emetics,  for  example,  inasmuch  as  the  cure  may  thereby,  in  many  instances, 
be  at  least  accelerated.  The  well-ascertained  influence  of  mercury  and 
iodine  on  the  glandular  and  assimilative  nerves,  naturally  points  to  those  two 
medicines  as  being  the  most  proper  for  consumption  ;  and  I  feel  it  my  duty 
to  state  to  you  that  I  have  often  availed  myself  of  their  beneficial  influence  in 
that  disease.  That  they  can  produce  it  in  cases  where  they  prove  constitu- 
tionally injurious,  you  will  scarcely  doubt,  when  you  consider  that  whatever 
may  injure  the  health  of  persons  predisposed  to  chest-disease,  may  as  cer- 
tainly bring  out  that  weak  point  of  their  frame.  Instances  produced  by  both, 
more  particularly  mercury,  I  have  too  often  been  compelled  to  witness. 

Medical  practitioners,  when  detailing  the  most  strikingly  remittent  pheno- 
mena, in  general  manage  so  to  word  them  that  you  cannot  distinguish  whether 
they  be  remittent  or  not.  The  more  intelligent  non-medical  writer  will  often 
convey  in  his  unsophisticated  English  the  precise  bearings  of  a  case.  Take 
an  instance  from  Captain  Hall's  narration  of  the  illness  of  the  Countess 
Purgstall :  "  Our  venerable  friend,"  he  says,  "  though  she  seemed  to  rally, 
and  was  certainly  in  as  cheerful  spirits  as  ever,  had  gotten  a  severe  shake  ; 
her  nights  were  passed  in  coughing,  high  fever,  and  sharp  rheumatic  pains, 
— but  in  the  day-time  she  appeared  so  well,  that  it  was  scarcely  possible  to 
believe  her  dying,  in  spite  of  her  constant  assertion  to  that  effect'."  [Srldoss 
Hainfield.]  Now,  in  such  a  cuse  as  this,  would  not  the  responses  of  the 
stethoscope  differ  materially  according  to  the  time  they  were  taken  ?  The 
indications  obtained  through  its  medium  could  not  possibly  be  the  same  by 
night  as  by  day. 

When  I  first  published  my  sketch  of  the  Chrono-Thermal  System  of 
Medicine,  I  had  the  misfortune,  among  other  things,  to  find  myself  at  issue 
with  certain  medical  critics  on  this  very  subject  of  tin'  stethoscope.  My  un- 
disguised contempt  for  their  wooden  idol  fired  two  of  them,  ;it  [east,  with  a 
common  indignation  ;  for  while  Dr.  Forbes,  in  hi^  Review,  made  this  a  rea- 
son for  pointing  out  to  me  --the  advantages  of  common  sense  over  the  want 
ot  it,"  1  found  myself  charged,  on  the  same  score,  in  the  pages  of  Dr.  James 
Johri-on,  with  "  profound  ignorance  and  inveterate  prejudice."  To  the 
strictures  ol  both  reviewers  1  replied  in  the  Lancet.     The  utter  inutility  of 


LECTURE  III.  73 

the  instrument  in  diseases  of  the  Heart  having,  as  you  have  seen,  been  since 
acknowledged  by  Dr.  James  Johnson  himself,  I  will  only  now  detain  you 
with  a  few  remarks  as  to  its  value  in  Pulmonary  Consumption. 

Permit  me,  I  said  to  my  very  polite  critics,  to  ask  you  a  very  plain  ques- 
tion.— Since  the  stethoscope  first  came  into  fashion,  have  you  or  any  other 
physician  been  able  to  bring  this  or  any  other  disease  of  the  chest  to  a  more 
favourable  termination  than  formerly  1  Hitherto,  I  never  could  obtain  but 
one  answer  to  this  question,  and  that  answer  was  always  a  negative.  But 
softly,  you  will  say — Has  it  not  taught  us  to  discriminate  and  distinguish  one 
disease  from  another  ?  Admitting  for  the  present,  that  such  is  the  fact,  (which 
however,  I  shall  shortly  disprove,)  of  what  use,  I  again  ask,  is  such  discrimina- 
tion, such  change  of  one  kind  of  verbiage  for  another,  if  it  lead  to  no  difference 
or  improvement  in  practice — if  our  remedial  measures,  for  all  shades  and  varia- 
tions of  pectoral  disorder,  comewit  last  to  the  same  agency  ?  What  is  it  but  a  vain 
waste  of  time  in  splitting  straws  to  attempt  to  distinguish  by  some  nice  auri- 
cular sign,  severe  disease  of  one  tissue  of  the  pulmonary  substance  from  an- 
other, if  the  proper  treatment  of  every  kind  of  lung  disorder  be  the  same  ? 
If  you  reply,  It  is  a  satisfaction  to  know  whether  the  disease  be  Curable  or 
not,  I  give  you  for  rejoinder  the  fact,  that  where  the  symptoms  are  so  grave 
as  to  be  with  difficulty  distinguished  from  true  tuberculous  consumption,  the 
disease,  in  that  case,  may  either,  like  such  consumption,  under  certain  cir- 
cumstances, admit  of  cure,  or,  like  the  same  disorder  in  its  very  advanced 
stages,  as  certainly  terminate  in  death. 

"  Rush,  Portal,  and  the  most  judicious  physicians,"  says  Dr.  Hancock, 
•'  have  constantly  regarded  Consumption  to  be  a  disease  of  the  constitution, 
not  consisting  merely  of  ulceration  or  loss  of  substance  in  the  lungs — of  course 
not  to  be  disposed  of  by  stethoscopes  or  any  oracular  mummery.  Hence,  too, 
We  see  the  reason  that  consumption  formerly,  in  the  times  of  Morton,  Syden- 
ham, Bennet,  and  others,  was  not  regarded  as  an  incurable  disease."  Let 
us,  however,  for  argument's  sake  allow  that  a  knowledge  of  the  exact  amount  of 
lung-decomposition  could  be  turned  to  some  useful  or  practical  account;  are  my 
critics  so  certain  that  the  stethoscope  is  adequate  to  the  detection  of  this  ? 
Andral,  an  authority  to  whom  "  pathologists"  on  all  occasions  implicitly  bow, 
candidly  admits  its  deficiency.  "Without  other  signs,"  he  says,  "  the  stetho- 
scope does  not  reveal  with  certainty  consumption  and  inflammations  of  the 
heart."  And  Dr.  Latham,  who  has  taken  no  small  pains  to  advocate  its  em- 
ployment, admits  that  the  best  Auscultators  even — the  technical  term  for 
those  who  use  it — have  been  led  to  a  wrong  prognostic  by  it.  "  To  most 
patients,"  he  adds,  "  1  fear  it  is  a  trouble  and  distress."  Now  this  is  just 
the  reason  why  I  repudiate  its  assistance;  whatever  troubles  and  distres- 
ses the  patient  must  not  only  alter  all  the  movements  of  his  heart  and  lungs, 
so  as  to  neutralise  the  whole  indications  presented  by  them  ;  but  must  ac- 
tually aggravate  the  state  of  his  system  throughout;  and,  by  consequence, 
instead  of  tending  to  the  relief  of  the  part  most  implicated,  must  further  increase 
its  diseased  state.  Well,  then,  as  the  information  obtained  from  the  stetho- 
scope must  from  the  nature  of  things,  be  as  hollow  and  empty  as  the  toy 
through  which  it  proceeds — and  as  the  discovery  of  the  degree  of  organic 
change,  even  could  it  be  known  to  a  nicety,  can,  in  no  instance,  lead  to  prac- 
tical imprpvement,  I  am  content  to  judge  of  it  from  the  patient's  general  ap- 
pearance, the  number  of  his  respirations,  and  the  sounds  emitted  when  he 
speaks,  breathes,  and  coughs,  as  appreciable  by  the  naked  ear.  From  an  in- 
strument whose  employment  troubles  and  distresses  the  majority  of 
patients,  I  look  for  no  superior  information ;  for,  I  repeat,  whatever  troubles 
and  distresses  people's  brains,  will  assuredly  trouble  and  distress  their  bodies, 
particularly  the  weaker  parts  of  them. 

Gentlemen,  we  are  all  liable  to  trust  too  much  to  our  ears.  In  Diseases  of 
the  Chest,  as  on  most  occasions,  we  should  do  well  to  examine  things  with 
our  eyes.     When  consulted  about  disorders  of  that  cavity,  our  business  is  to 


74  LECTURE  III. 

watch  well  the  countenance  of  the  patient,  to  mark  whether  his  breathing  be 
hurried,  or  the  reverse,  whether  he  has  lost  flesh,  or  begins  to  gain  it ;  and 
from  whatever  part  of  the  lungs  the  matter  expectorated  may  proceed,  we 
can  be  at  no  loss  for  the  proper  principle  of  treatment ;  our  eyes  will  soon 
tell  us  whether  he  gets  better  or  worse,  and  whether  a  particular  medicine 
should  be  continued  or  changed  for  another.  In  the  case  of  any  very  mate- 
rial change  in  the  lungs,  such  as  an  abscess,  cavern,  or  solidification  of  a  part 
of  their  substance,  if  large,  such  local  disease  will  get  smaller  as  the  general 
health  improves, — if  small,  it  will  grow  larger  should  that  get  worse.  More 
than  this, 

There  need  no  words,  nor  terms  precise — 

The  paltry  jargon  of  the  Sdiools, 

Where  Pedantry  gulls  Folly; — we  have  eyes  ! 

With  these,  then,  let  us  recur  to  Nature,  an#we  shall  have  no  need  to  ask 
of  professors  and  other  great  persons  whether  consumption  and  other  chest- 
affections,  be  remittent  disorders  or  not.  When  once  satisfied  of  that,  you, 
Gentlemen,  may  be  sure  that  quinine,  opium,  and  the  other  Chrono-Thennal 
medicines,  will  be  of  infinitely  more  avail  for  their  cure  than  all  the  discus- 
sion and  discrimination  of  all  the  doctors  that  ever  mystified  disease  by  their 
vain  nosologies !  What  cares  the  patient  about  the  alphabetical  combination, 
by  which  you  baptize  his  disease,  if  you  cannot  make  him  better ;  and  if  you 
succeed  in  curing  him,  what  dc^s  it  signify,  wh'ether  you  call  it  one  name  or 
another  ?  But  the  name,  it  may  be  said,  has  to  do  with  the  prognostic.  To 
that  I  reply, — Even  when  despairing  of  success,  you  will  do  well  to  guard 
yourselves  against  a  too  decided  prognostic  in  any  case.  How  often  have  I 
heard  patients,  who  had  formerly  suffered  from  chest-disease,  boast  that  they 
had  lived  to  cheat  their  doctor  of  the  death  to  which  he  had  theoretically 
doomed  them, — ay,  and  that  doctor  a  stethoscopist ! 

It  is  truly  amusing  to  find  men  playing  the  critic,  without  the  smallest  pre- 
tension to  the  knowledge  rerjpftftite  for  such  an  office.  So  ignorant  was  my 
Medico- Chirurgical  Reviewer,  Dr.  James  Johnson,  of  one  of  the  most  uni- 
versal laws,  both  of  Health  and  Disorder,  as  to  accuse  me  of  a  limited  grasp 
of  my  profession,  for  making  FeVer, — "  not  Fever  in  the  large  sense  of  the 
word,  but  only  Remittent  fever," — my  primitive  type  of  all  diseases.  He 
chuckled  that  he  could  confront  me  with  the  school-boy  term,  "Continued 
Fever,"  "  Fever  in  the  large  sense  of  the  word  ;"  but  according  to  a  living 
professor,  Dr.  A.  T.  Thompson,  in  Continued  Fever,  in  almost  every  case, 
there  is  an  Exacerbation  towards  mid-day,  and  the  Remission  towards"  morn- 
ing. Another  contemporary,  Dr.  Shearman,  says,  "an  Intermittent  is  the 
most  perfect  form  of  fever,  having  the  most  complete  periods  of  accession  and 
intermission.  _  The  Continued  Fever,  as  it  is  called,  differs  from  this  only  in 
its  periods  being  less  perfect  and  the  stages  of  its  curriculum  less  obvious."— 
Cullen  long  ago  said  the  same  thing  in  nearly  the  same  words  ;  and  almost 
every  other  writer  on  fever  since  his  time  has  noticed  it.  But  so  great  n 
blunder,  in  the  eyes  of  Dr.  Johnson,  was  my  preference  of  the  perfect  rather 
than  the  imperfect  form  of  fever,  for  mv  type  of  all  disease,  that  he  not  only 
condemned  my  doctrine  in  toto,  as  a  Pyrexy- Mania,  or  fever  madness,  but 
he  assured  his  readers  my  madness  had  a  method  in  it.  Gentlemen,  whether 
or  not  Dr.  James  Johnson's  own  practice  does  better  deserve  to  come  under 
the  head  of  madness, — savouring,  too,  of  a  rather  sanguinary  and  homicidal 
type  of  it — I  shall  by-and-by  have  an  opportunity  of  snowing  you.  Mean- 
time I  may  observe,  that — 

Though  I  hope  not  hence  unscathed  to  go, 

Who  conquers  me  snail  find  a  stubborn  Ice  ! 

The  time  hath  been  when  no  harsh  sounds  would  fall 

From  lips  that  now  would  seem  imbued  with  gall, 

Nor  ti>ols,  nor  follies  tempi  mo  to  despise 

The  meanest  thing  that  crawls  benenlli  I 


LECTURE  III.  75 

But  tiow  so  callous  grown,  so  changed  since  youth, 

I've  learned  to  think,  and  sternly  speak  the  Truth, — 

Learned  to  deride  the  critic's  starch  decree, 

And  break  him  on  the  wheel  he  meant  for  me ; 

To  spurn  the  rod  a  scribbler  bids  me  kiss, 

Nor  care  if  courts  or  crowds  applaud  or  hiss. — Byron. 

Having  already  adverted  to 

Glandular  Disease, 

I  will  just  shortly  observe,  that  complaints  of  this  kind,  whether  involving 
some  large  gland  such  as  the  Liver,  Pancreas,  or  Spleen, — if  the  last  men- 
tioned viscus  be  indeed  a  gland — or  taking  place  in  the  glandular  apparatus 
of  canals,  the  lachrymal  and  biliary  ducts,  the  eustachian,  salivary,  and 
urinary  passages,  for  example, — such  disorders  may  all  be  advantageously 
treated  by  the  various  Chrono-Thermal  medicines,  and  more  certainly  so,  if 
combined  with  minute  doses  of  Iodine,  Mercury,  and  other  remedies  which 
have  a  well  known  glandular  affinity.  Disorders  of  the  smaller  glands, 
whether  situated  in  the  neck,  arm-pit,  or  groin,  or  in  the  course  of  the 
mesentery,  are  for  the  most  part  termed  "scrofula,"  and  by  some  practitioners 
presumed  to  be  incurable, — than  which  nothing  can  be  more  erroneous, 
unless  it  be  the  system  which  renders  them  so ;  namely,  the  application  of 
leeches  to  the  tumours,  and  the  purgatives  so  unsparingly  employed  by  many 
in  their  treatment.  All  these  various  diseases  are  features  or  effects  of  Re- 
mittent Fever  ;  by  controlling  which  with  the  chrono-thermal  agents,  they 
may  all,  in  the  earlier  stages,  be  at  once  arrested  ;  and  some,  even  of  a 
chronic  character,  perfectly  cured  by  a  combination  of  these  remedies  with 
mercury  or  iodine.  I  could  give  cases  innumerable  in  proof  of  this,  but  as  I 
have  so  well  established  the  principle  in  structural  disease,  and  have  still 
further  to  illustrate  it  in  the  disorders  we  are  about  to  enter  upon,  I  shall  not 
detain  you  further  on  this  matter. 

Consumptive  Diseases  of  Joints. 

Very  much  akin  to  Consumption  of  the  Lungs,  are  various  diseases,  which, 
from  their  external  manifestations,  have  been  too  long  left  under  the  exclusive 
dominion  of  the  Surgeons ;  namely,  those  destructive  affections  of  the  Joints, 
which  so  often  bring  the  subjects  of  them  to  the  amputating  table.  I  forget 
the  particular  operative  eminent  who  thanked  God  he  knew  nothing  of 
physic !  Such  a  confession  was  very  proper  for  a  butcher — for  the  barber- 
surgeons  of  former  ages ;  but  the  medical  man  who,  by  well-directed  reme- 
dies, prefers  the  honest  consciousness  of  saving  his  patient  from  prolonged 
suffering  and  mutilation,  to  the  spurious  brilliancy  of  a  name  for  "  Opera- 
tions," will  blush  for  the  individual  whose  only  title  to  renown  was  the  bliss 
of  his  boasted  ignorance,  and  a  mechanical  dexterity  of  hand  unenviably  ob- 
tained by  an  equally  unjustifiable  waste  of  human  blood.  It  is  truly  atrocious 
in  the  legislature  of  this  country  to  permit  the  present  hospital  system, — a 
system  that  only  encourages  ignorance,  presumption,  and  heartless  cruelty. 
No  man  in  his  senses  would  put  himself  under  the  care  of  an  "  Hospital 
Surgeon,"  if  he  knew  that  scarcely  one  of  those  self-conceited  creatures  is  in 
the  very  least  acquainted  with  physic.  What  would  some  of  these  superci- 
lious mechanics  say  to  the  following  cases  ? 

Case  1. — Harriet  Buckle,  seven  months  old,  had  what  is  called  a  scrofu- 
lous elbow.  The  joint  was  much  enlarged,  red,  painful,  and  previous  to  the 
probe,  with  discharge.  The  patient  was  the  subject  of  diurnal  fever.  Not- 
withstanding the  assurances  of  the  mother  that  amputation  had  been  held  out 
as  the  only  resource  by  two  "  hospital  surgeons,"  under  whose  care  the  child 
had  previously  been,  I  confidently  calculated  on  success.  A  powder  contain- 
ing calomel,  quinine,  and  rhubarb,  in  minute  doses,  was  directed  to  be  taken 
every  third  hour.  The  case  was  completely  cured  in  a  fortnight,  without 
any  external  application. 


76  LECTURE  III. 

Case  2. — A  young  gentleman,  aged  11  years,  had  enlarged  knee,  with  great 
pain  and  heat,  which  came  on  in  paroxysms.  Leeches,  blisters,  and  purga- 
tives had  all  been  ineffectually  tried  by  his  "  hospital  surgeon,"  who  then 
proposed  amputation  ;  the  boy*s  mother  hesitated,  and  I  was  called  in.  I 
prescribed  minute  doses  of  calomel  and  quinine.  From  that  time  the  knee 
gradually  got  better,  but  stiff  joint  was  the  result;  anchylosis  or  adhesion 
having  taken  place  before  I  was  consulted. 

Case  3. — Another  young  gentleman,  aged  seven  years,  son  of  Lord  C , 

was  brought  to  me  from  Brighton,  with  his  knee  as  large  as  a  young  child's 
head  ;  abscesses  had  formed  about  the  joint,  and  were  still  discharging  when 
I  first  saw  him.  I  prescribed  chrono-thermal  treatment ;  and  notwithstand- 
ing that  his  limb  had  been  condemned  to  the  knife  by  his  Brighton  "  hospital 
surgeon,"  I  obtained  a  complete  cure ;  a  partial  anchylosis  only  remaining. 
He  had  also  been  a  patient  of  Sir  B.  Brodie  before  I  was  consulted. 

Case  4 — A  boy,  aged  six,  began  to  lose  flesh,  to  walk  lame,  and  to  com- 
plain of  pain  of  knee,  stooping  occasionally  to  place  his  hand  upon  it  when  he 
walked.  There  was  some  alteration  in  the  appearance  of  the  hip  of  the  same 
side,  when  I  was  requested  to  see  him.  I  adopted  a  similar  treatment  as  in 
the  above  case,  and  the  child  rapidly  recovered  his  health,  with  the  com- 
plete use  of  his  limb.  He  had  been  previously  seen  by  a  surgeon,  who, 
though  the  knee  was  the  painful  part,  rightly  pronounced  the  case  to  be  one 
of  Hip-disease.  To  the  knee,  as  you  know,  instead  of  the  hip,  the  little  pa- 
tient constantly  refers  his  complaint,  a  circumstance  which  occasionally 
deceives  the  attending  practitioner,  as  to  the  nature  and  locality  of  this  destruc- 
tive disease. 

Case  5. — A  girl,  aged  12,  had  enlarged  ankle,  with  an  open  ulcer  leading 
into  the  joint.  Amputation,  according  to  the  mother,  was  looked  upon  as  the 
inevitable  termination  of  the  case  by  two  "  hospital"  surgeons,  under  whose 
care  the  patient  had  been  for  twelve  months  previously  to  my  seeing  her. — 
With  small  doses  of  quinine  and  calomel,  the  girl  regained  her  health,  and  the 
ankle  got  well  in  six  weeksi 

The  curious  in  Nosology  (br  the  art  of  naming  diseases)  might  demand  the 
technical  terms  for  these  various  affections.  Will  they  be  content  with  the 
simplicity  of  Joint  Consumption  ?  Truly,  in  surgical  authors,  they  may 
find  verbiage  enough  to  distinguish  them  all,  such  as  "  Scrofula,"  "  White- 
swelling,"  "  Morbus  Coxarius,"  "  the  Evil,"  &c.,  but  whether  or  not  these 
words  be  explanations,  I  leave  to  more  learned  heads  than  mine  to  decide. 

There  is  not  a  disease,  Gentlemen,  however  named  or  by  whatever  cause, 
of  which  the  most  perfectly  periodic  examples  might  not  be  given  ;  and  the 
only  difference  between  diseases  in  this  type,  and  their  more  apparently  con- 
tinued forms,  is,  that  the  periods  of  the  latter  are  less  perfect,  und  the  stages 
of  their  curriculum  less  marked  than  in  the  former.  No  physician  will  doubt 
that  a  purely  periodic  disease,  whatever  be  its  nosological  name,  partakes 
of  the  nature,  and  is  more  or  less  amenable  to  the  treatment  successfully  fol- 
lowed in  ague.  Why,  then,  deny  that  the  same  disease,  when  less  obviously 
periodic,  partakes  of  that  variety  of  ague  misnamed  "  Continued"  Fever, 
since  all  disorders  like  it  have  remissions  and  exacerbations,  more  or  less  per- 
fect in  character,  throughout  their  whole  course  ?  What  are  such  diseases 
but  varieties  of  the  more  purely  intermittent  type  ?  And  what  the  remedies 
found  to  be  most  beneficial  in  "their  treatment,  but  the  remedies  of  the  most 
acknowledged  efficacy  in  simple  ague  ? 

Remission  and  paroxysm  are  equally  the  law  of  what  are  termed  load  dis- 
eases, as  of  the  more  general  symptoms  which  are  supposed  to  be  the  ex- 
clusive province  of  the  physicians.  John  Hunter  Beems  to  lie  the  only 
Burgeon  who  has  remarked  this: — "  Exacerbations,"  he  says,  »  are  common 
to  all  constitutional  diseases,  and  would  often  appear  to  belong  to  many  local 
complaints. "  Gentlemen,  they  belong  to  all.  You  may  observe  them  even 
jn  the  <-;t-.e  of  disease  from  local  injury  ;  and  here  1  may  give  you  an  instance 
in  illustration  of  this,  contained  in  a  letter  tome  from  Mr.  Radley,  of  Newton 


LECTURE  IV.  77 

Abbot,  Devon,  a  gentleman  well  known  for  his  improved  method  of  treating 
fractures.  Mr.  Radley  writes  thus  : — "  Many  thanks  to  you  for  the  '  Unity 
of  Disease,'  which  contains  in  it  more  of  the  true  philosophy  of  medicine  than 
any  book  I  have  ever  yet  seen.  There  are  some  passages  that  threw  me 
into  an  extacy  of  delight  on  reading  them.  On  the  other  side,  I  send  you  a 
case  strikingly  illustrative  of  the  truth  of  your  new  doctrine,  and  one  that 
was  presented  to  me  in  my  own  favourite  class  of  subjects.  It  was  not 
elicited  by  inquiry,  but  thrust  most  unexpectedly  upon  my  notice;  and  had 
not  your  work  prepared  me  for  such  a  fact,  I  will  be  so  candid  as  to  say  the 
fact  would  have  been  lost  upon  me  : — G.  Manning,  aged  42,  fractured  the 
tibia  on  the  2nd  instant.  It  was  a  simple  fracture,  with  much  contusion. 
To  soothe  the  pain,  he  had  a  solution»oif  morphia,  after  the  limb  had  been 
laid  on  the  pillow.  When  three  days  had  elapsed,  he  still  complained 
of  pain,  and  on  my  inquiring  when  he  suffered  most,  '  Why,  zur,  'tis  very 
curious  to  me,  for  pain  comes  every  twelve  hours  quite  regular,  about  mid- 
night, when  it  lasts  one  hour  and  a  half  or  two  hours,  and  again  in  the  middle 
cf  the  day.'     The  patient  is  now  doing  well  under  Baric." 

Every  surgeon  of  experience  is  aware  of  the  severe  and  occasionally  fatal 
operations  resorted  to,  for  the  purpose  of  obtaining  a  reunion  of  the  fractured 
bones  in  particular  constitutions ;  of  the  setons  which  have  been  passed  be- 
tween their  ends,  and  of  the  knives  and  saws  by  which  they  have  been  scraped 
and  pared— these  horrible  local  means  for  constitutional  effects.  Dr.  Colles, 
of  Dublin,  indeed,  introduced  a  constitutional  mode  of  treating  such  cases ; 
but  it  was  confined  to  otoe  medicine,  mercury,  and  that  failing  in  other  hands, 
it  has  not  been  generally  followed.  Several  years  ago,  while  in  medical 
charge  of  Her  Majesty's  30th  Foot,  in  the  East  Indies,  it  was  my  fortune 
to  obtain  the  most  satisfactory  result,  in  the  case  of  a  soldier  of  that  regiment, 
by  the  exhibition  of  quinine.  The  man  had  remittent  fever — the  true 
constitutional  reason  why  fractured  bones  refuse  to  unite  under  ordinary 
means. 

Inquire  of  the  subject  of  Goitre  or  other  tumour ;  question  the  unfortunate 
persons  who  ask  your  advice  in  cases  of  cancer  ;  such  as  suffer  from  abscess 
or  ulcer  ;  or  those  even  who  consult  you  for  the  true  aneurismal  tumour  of 
an  artery  ;  and  each  and  all  will  admit,  that  they  are  one  clay  better,  another 
worse  ;  that  their  swellings  at  intervals  decrease  ;  that  their  ulcers  become 
periodically  more  or  less  painful ;  that  the  size  of  both  varies  with  the  varia- 
tions of  heat  and  cold,  damp  or  moisture  of  the  weather  ;  that  their  diseases 
are  often  materially  influenced  by  a  passion,  or  by  good  or  bad  news ;  that 
in  the  commencement,  at  least,  there  are  days,  nay,  hours  of  the  same  day, 
when  they  have  a  certain  respite  from  their  pain  and  suffering ;  and  that  they 
all  experience  in  their  bodies  the  thermal  variations  which  we  call  fever ; 
some  referring  these  last  to  the  head  or  back,  while  others  associate  them 
with  the  chest,  loins,  arms,  or  feet.  Gentlemen,  can  you  doubt  the  advantage 
of  pursuing  a  chrono-thermal  system  of  practice  in  such  cases  ? 

For  the  present  we  must  pause.  Our  next  business  shall  be  to  explain  the 
meaning  of  the  word  inflammation,  and  to  expose  the  terrible  errors  daily 
committed  in  the  treatment  of  cases  so  called. 


LECTURE  IV. 

inflammation — blood-letting — abstinence. 

Gentlemen, 

When  medical  men  hear  that  I  am  in  the  habit  of  treating  all  kinds  of 
disease  without  blood-letting,  they  generally  open  their  eyes  with  a  stare,  and 
ask  me  what  I  do  in  Inflammation.    Inflammation !  who  ever  saw  any 


78  LECTURE  IV. 

part  of  the  body  on  fire,  or  in  flames  ?  for  the  word,  if  it  means  anything  at 
all,  must  have  something  like  that  signification.  To  be  sure,  we  have  all 
heard  of"  spontaneous  combustion,"  but  1  confess  I  never  saw  it,  nor  what  is 
more,  anybody  that  ever  did  !  What,  then,  is  this  inflammation — this  term 
which  our  great  modern  doctors  so  dogmatically  assure  us  is  the  head  and  front 
of  every  corporeal  disorder  ?  It  is  a  metaphor  merely — a  theoretic  expres- 
sion, which,  torture  it  how  you  please,  can  only  mean  a  quicker  motion  and 
a  higher  temperature  in  the  moving  atoms  of  a  given  structure,  than  are  com- 
patible with  the  healthy  organisation  of  that  structure.  When  you  find  a  con- 
siderable degree  of  heat  and  swelling,  with  pain  and  redness  in  any  part,  that 
part,  in  medical  language,  is  "inflamed."  Now,  what  are  these  phenomena 
but  the  signs  of  approaching  structu/al  decomposition  ?  During  the  slighter 
corporeal  changes,  the  coincident  variation  of  temperature  is  not  always  very 
sensibly  perceptible  ;  but  whenever  there  is  the  least  tendency  to  decompo- 
sition, this  thermal  change  is  sure  to  be  one  of  the  most  prominent  features. 
The  phenomena  termed  inflammation,  then,  very  closely  resemble  the  chemi- 
cal phenomena  which  take  place  preceding  and  during  the  decomposition  of 
inorganic  substances.  Now,  when  this  kind  of  action  proceeds  unchecked, 
the  result  in  most  cases  is  a  tumour,  containing  purulent  matter  ;  which  mat- 
ter being  a  new  fluid  product,  differs  entirely  in  its  appearance  and  consist- 
ence from  the  original  solid  tissue,  in  which  it  chanced  to  become  developed. 
This  tumour  we  call  Abscess.  And  how  is  it  to  be  cured  ?  Jn  most  in- 
stances, the  matter,  after  working  its  way  to  the  surface,  escapes  by  an  ulce- 
rated opening  of  the  integument ;  while  in  others,  an  artificial  opening  must 
first  be  made  by  the  knife  of  the.  surgeon.  In  either  case,  the  part  in  which 
the  abscess  was  situated,  generally  recovers  its  healthy  state  by  the  repara- 
tive powers  of  nature.  But  there  is  yet  another  mode  in  which  a  cure  may 
be  effected,  namely,  by  Absorption  ;  that  is  to  say,  the  matter  of  the  abscess 
may  be  again  taken  up  into  the  system,  and  by  the  inscrutable  chemistry  of 
life,  become  once  more  part  and  parcel  of  the  healthy  fabric  of  the  body  ! — 
being  thus  again  reduced  to  the  elements  out  of  which  it  was  originally 
formed.  How  analogous  all  this  to  the  operations  of  the  chemist,  who,  by 
means  of  the  galvanic  wire,  having  first  reduced  water  into  its  elemental 
gases,  again,  by  electrical  means,  converts  them  into  the  water  from  whose 
decomposition  they  proceeded  !  Such,  and  many  more  chemical  operations, 
Nature  daily  performs  in  the  animal  body  ;  and  that  she  does  all  this  through 
the  vito-electric  medium  of  the  Brain  and  Nerves,  cannot  possibly  admit  of 
dispute,  when  you  come  to  consider  that  under  the  influence  of  a  Passion 
(the  most  unquestionable  of  cerebral  actions)  abscesses  of  considerable  size, 
and  even  solid  tumours,  have  often  completely  disappeared  in  a  single  niiiht. 
Gentlemen,  there  is  not  a  passion, — Grief,  Rage,  Terror,  or  Joy, — which  has 
not  as  effectually  cured  abscesses  and  other  tumours,  as  the  most  powerful 
agents  in  the  materia  medica.  The  writings  of  the  older  authors  abound  in 
instances  of  this.  But  there  are  yet  other  terminations  to  the  inflammatory 
process.  For  example:  after  having  proceeded,  to  a  certain  extent,  in  the 
way  of  change,  but  still  falling  short  of  actual  purulent  decomposition,  the 
atoms  of  the  inflamed  part,  by  the  renewal  of  a  healthy  condition  of  the  body 
generally,  or  by  the  direct  application  of  cold  or  other  agency,  may  again, 
with  more  or  less  quickness,  subside  into  the  degree  of  motion  ami  tempera- 
ture characteristic  of  their  natural  revolutions.  This  termination  is  called 
Resolution.  When  the  inflammatory  action  is  more  than  usually  rapid,  the 
result  may  be  the  complete  death  of  the  part  Implicated, — a  black  inorganic 
mass  being  left  in  the  place  of  the  tissue  which  it  originally  composed.  This 
last  we  term  Mortification  or  Gangrene. 

But,  Gentlemen,  medical  men  extend  the  term  inflammation  to  some  other 
morbid  processes,  which,  under  the  various  names  of  Gout,  Rheumatism,  and 
Erysipelas,  we  shall,  in  another  lecture,  have  the  honour  to  explain  to  you. 
A  great  many  books  have  been  written  upon  this  subject  of  Inflammation*  but 


LECTURE  IV.  79 

I  must  own  I  never  found  myself  one  whit  the  wiser,  after  reading  ary  of 
them.  Their  writers,  in  almost  every  instance,  use  language  which  they  do 
not  themselves  seem  to  have  understood,  otherwise  they  would  have  confined 
themselves  to  one  sense,  instead  of  including  under  the  same  term  states  the 
most  opposite.  Were  I  to  tell  you  that  the  word  "  Inflammation"  is  used  by 
many  writers  when  a  part  is  more  than  usually  cold,  you  would  think  I  was 
laughing  at  3rou  ;  yet  there  is  nothing  more  true,  and  I  will  give  you  an  in- 
stance. A  carpenter  had  his  thumb  severely  bitten  by  a  rattlesnake ;  and 
the  effects  of  the  venom  are  thus  described  by  Mr.  Samuel  Cooper,  in  his 
lectures,  published  in  the  Medical  Gazette  :  "  The  consequence  was,  that  in 
tea  or  eleven  hours,  the  whole  limb,  axilla,  and  shoulder  became  very  cold 
and  enormously  swollen  up  to  the  neck  ;  in  fact,  the  surface  of  the  whole 
body  was  much  below  the  natural  temperature.  The  swelling,  you  know,  is 
produced  by  that  kind  of  inflammation  which  is  called  diffuse  inflammation 
of  the  cellular  tissue."  Gentlemen,  was  there  ever  such  an  abuse  of  words  ; 
such  an  abandonment  of  common  sense  as  this  ?  The  arm  was  "  very  cold" 
— "  much  below  the  natural  temperature," — yet  it  was  inflamed — on  fire  ! 

Restricted  to  the  sense  in  which  I  have  already  spoken  of  the  term, — 
namely,  heat,  redness,  swelling,  and  pain, — "  Inflammation,"  like  "  Fever," 
or  any  other  abstract  word,  may  be  used  as  a  "  counter  to  reckon  by ;"  and, 
like  almost  every  other  phenomenon  of  disease,  it  is  a  developement  of  pre- 
vious constitutional  disturbance.  I  do  not  speak  of  immediate  local  inflam- 
mation produced  by  a  chemical  or  mechanical  injury — leaving  that  to  the 
surgeons  to  elucidate  or  mystify,  according  to  their  particular  inclinations  ;  I 
talk  of  inflammation  from  a  general  or  constitutional  cause.  Has  an  individual, 
for  example,  exposed  himself  to  a  cold  draught,  or  to  any  other  widely  inju- 
rious influence,  he  shivers,  fevers,  and  complains  of  pain,  throbbing,  and  heat 
in  the  head,  chest,  or  abdomen, — phenomena  gradually  developed  according 
to  the  patient's  predisposition  to  organic  change  in  this  or  that  locality. 
Phrenitis,  Pneumonia,  Peritonitis,  (technical  terms  for  inflammation  of  the 
Brain,  Lungs,  and  membraneous  covering  of  the  Bowels,)  are  consequences 
or  features,  not  causes  of  the  constitutional  disorder.  But  do  the  S}-2nptoms 
of  inflammation  in  such  parts  become  as  perfectly  intermittent  as  the  diseases 
of  which  we  have  already  treated?  Listen  to  Lallemand  :  "In  inflamma- 
tion of  the  brain,"  he  tells  you,  "  you  have  spasmodic  symptoms,  slow  and 
progressive  paralysis,  the  course  of  the  disorder  being  intermittent."  Dr. 
Conolly,  in  his  Cyclopaedia  of  Medicine,  says,  "  Diurnal  remissions  are  dis- 
tinguished in  evert  attack  of  inflammation."  Now,  if  you  prefer  the  evi- 
dence of  another  man's  eyes  to  your  own,  this  statement  ought  to  be  more 
than  convincing,  for  it  comes  from  the  enemy's  camp.  It  is  the  language  of 
a  gentleman  who  was  formerly  one  of  the  editors  of  the  British  and  Foreign 
Medical  Review,  a  publication  that  first  opposed  my  doctrines,  and  afterwards 
attempted  to  give  the  credit  of  them  to  another. 

Whether  the  particular  condition  called  Inflammation  be  termed  erysipe- 
loid, gouty,  rheumatic,  scrofulous,  it  is  still  remittent ;  and  if  you  question 
the  patient,  he  will  in  almost  every  case  admit  that  it  was  preceded  or  ac- 
companied by  cold  or  hot  fits,  or  both.  May  not  inflammation,  then,  yield  to' 
Bark — to  Quinine?  The  late  Dr.  Wallace,  of  Dublin,  maintained  the 
affirmative,  dwelling  more  particularly  on  its  good  effects  in  that  disorganis- 
ing inflammation  of  the  Eye,  termed  Iritis,  in  which  disease  he  preferred  it 
to  all  the  routine  measures  which,  on  the  strength  of  a  theory,  medical  men 
have  from  time  to  time  recommended  as  "  antiphlogistic."  During  an  attack 
of  Ague,  he  tells  us,  Iritis,  with  inflammatory  affection  of  other  parts  of  the 
eye,  occurred  in  the  person  of  a  patient  under  his  care.  "  For  the  former 
complaint,  namely,  the  Intermittent  Fever,  he  administered  Bark  ;  by  the 
exhibition  of  which,  he  was  surprised  at  seeing  the  inflammatory  affection  of 
the  Eye,  as  well  as  the  fever,  disappear."  This  was  the  case  which  first 
led  him  to  suspect  the  fallacy  of  the  blood-letting  system  in  inflammation  of 


80  LECTURE  IV. 

the  Eye.  Now  I  shall  tell  you  what  first  led  me  to  entertain  similar  doubts 
of  its  efficacy.  A  medical  officer  of  one  of  her  majesty's  regiments  serving 
in  India,  couched  a  woman  for  cataract.  The  next  day,  the  eye  having 
become  inflamed,  according  to  received  practice  he  bled  the  patient ; 
but  scarcely  had  he  bound  up  her  arm,  when  she  fell  as  if  she  had  been 
Bhot,  and  lay  to  all  appearance  dead.  With  the  greatest  difficulty,  he 
succeeded  in  recovering  her  from  this  state ;  but  it  was  not  till  four 
long  hours  had  passed,  that  he  felt  he  could  safely  leave  her  with  ordi- 
nary attendance  ;  for  during  the  greater  part  of  that  time,  when  he  ceased  to 
chafe  her  temples,  or  otherwise  call  up  the  attention  of  the  brain  by  the  ap- 
plication of  stimulants  to  the  nose,  mouth,  <kc,  she  relapsed  into  a  death-like 
swoon.  More  than  once  he  was  even  obliged  to  inflate  her  lungs  to  keep  her 
from  dying.  But,  in  this  case,  Gentlemen,  the  blood-letting  did  not  cure  the 
inflammation  ;  for  the  next  day  the  eye  was  more  painful  and  inflamed  than 
ever,  and  the  poor  woman,  after  all  the  blood  she  had  lost — and  who  will  say 
that  she  was  not  bled  ? — did  not  recover  her  sight.  It  is  now  many  years 
since  that  case  came  under  my  observation,  and  it  made  an  impression  on  my 
mind  I  shall  never  forget.  Had  that  woman  died,  would  not  everybody  have 
said  that  the  gentleman  who  bled  her  had  killed  her?  and  very  justly,  too  ; 
though  he,  good  man,  only  conscientiously  put  in  practice  what  he  had  been 
taught  to  consider  his  duty.  You  see,  then,  that  blood-letting,  even  to  the 
point  of  death,  is  no  cure  for  inflammation  ;  that  it  is  equally  powerless  in  pre- 
venting the  development  of  inflammation,  I  shall  furnish  you  with  ample 
evidence  before  I  finish  this  lecture.  Meantime,  I  will  tell  you  what 
can  do  both — bark  and  opium.  These  are  the  remedies  to  give  before  an 
operation,  and  they  are  also  the  remedies  best  adapted  for  the  relief  of  inflam- 
mation after  it  has  come  on  ;  and  their  beneficial  influence  will  be  more  gene- 
rally curtain  in  the  latter  case,  if  you  first  premise  an  emetic,  and  wait  till 
its  action  has  ceased  before  you  administer  them. 

"  The  Peruvian  bark,"  says  Heberden,  "  has  been  more  objected  to  than 
any  of  these  medicines  (bitters)  in  cases  of  considerable  inflammation,  or 
where  a  free  expectoration  is  of  importance ;  for  it  is  supposed  to  have,  be- 
yond any  other  stomach-medicine,  such  a  strong  bracing  quality,  as  to  tighten 
"the  fibres  (!)  still  more,  which  were  already  too  much  upon  the  stretch  in  in- 
flammation ;  ,and  its  astringency  has  been  judged  to  be  the  likely  means  of 
checking  or  putting  a  stop  to  expectoration."  All  this  appeared  much  more 
plausible  when  taught  in  the  schools  of  physic,  than  probable,  when  I 
attended  to  fact  and  experience.  The  unquestionable  safety  and  acknowledged 
use  of  the  bark,  in  tne  worst  stage  of  inflammation,  when  it  is  tending  to  a 
mortification,  affords  a  sufficient  answer  to  the  first  of  these  objections  ; 
and  I  have  several  times  seen  it  given  plentifully  in  the  confluent  small-pox, 
without  lessening  in  any  degree  the  expectoration." 

Some  time  ago,  I  was  called  to  see  a  young  gentleman,  who  had  a  swell- 
ing under  the  armpit,  extending  to  the  side.  The  skin  was  red  and  hot,  and 
the  tumour  so  painful  as  to  have  deprived  him  of  all  rest  for  the  three  pre- 
vious nights.  Though  suppuration  appeared  to  me  to  have  commenced,  1  at 
once  ordered  quinine,  and  begged  him  to  poultice  the  tumour.  By  these 
means,  he  was  perfectly  cured  in  three  days,  the  swelling  having,  in  that 
period,  completely  disappeared.  The  subject  of  this  case  was,  in  the  first 
instance,  attacked  with  shivering  and  fever,  which  had  repeatedly  recurred, 
but  disappeared  under  the  use  of  the  quinine.  Matter,  I  have  no  doubt,  was 
absorbed  in  this  instance,  but  so  far  from  this  absorption  producing  ebiveringfi 
— which,  according  to  the  doctrine  of  the  schools,  it  ought  to  have  done — the 
"cry  reverse  took  place. 

I   shall  now  give  you  one  of  many  instances  of  indubitable  and  palpable 

imation — if  the  word  have  a  meaning  at  all — as  a  proof  of  the  value  of 

opium  in  the  treatment  of  this  affectiom    An  old  officer,   Major  1'.,  B9th 

Foot,  who  had  previously  lost  one  eye  in  acute  ophthalmia,  notwithstanding 


LECTURE  IV.  81 

a  vigorous  "  antiphlogistic"  discipline,  had  the  other  attacked  in  a  similar  man- 
ner with  great  pain,  redness,  and  throbbing.  I  found  him  leaning  his  head 
over  a  chair-back,  his  face  indicative  of  intense  agony.  For  ten  nights,  he 
assured  me  he  had  been  unable  to  tolerate  any  other  position,  and  it  was  only 
towards  morning,  when  overcome  by  sutfering,  that  he  could,  at  last,  obtain 
anything  like  repose.  The  pain  came  on  at  bed-time,  in  an  aggravated  de- 
gree, and  remitted  principally  in  the  afternoon.  Three  grains  of  opium, 
which  I  directed  him  to  take  half-an-hour  before  the  recurrence  of  the  expected 
paroxysm,  procured  him  a  whole  night  of  profound  sleep,  and  his  eye,  in  the 
morning,  to  his  astonishment,  was  free  from  pain,  and  only  slightly  vascular. 
He  had  been  repeatedly  bled,  leeched,  purged,  and  blistered,  without  even 
temporary  benefit — indeed,  the  gentleman  who  attended  him,  in  the  first 
place,  plumed  himself  upon  the  activity  of  his  treatment. 

But  how,  you  may  ask  me,  can  Pleurisy  and  Pneumonia  be  cured  with- 
out blood-letting  7  What  are  pleurisy  and  pneumonia  ?  Any  rapid  tendency 
to  change  in  the  substances  of  the  lungs,  from  the  real  pain  and  presumed 
increase  of  temperature  at  the  same  time  developed,  is  termed  Pneumonia — 
vulgo  inflammation  of  the  lungs.  A  similar  tendency  to  change  in  the  sub- 
stance of  the  membrane  (pleura)  which  covers  the  outer  surface  of  the  lungs, 
or  of  that  portion  of  it  which  is  continued  over  the  inner  surface  of  the  chest, 
is  called  Pleurisy.  Now,  authors  have  thought  it  a  fine  thing  to  be  able  to 
tell  pleurisy  from  pneumonia,  but  the  thing  is  impossible  ;  and  what  is  more, 
if  it  were  possible,  so  far  as  the  treatment  is  concerned,  it  would  not  be  worth 
the  time  you  should  spend  in  doing  it.  Such  distinctions  only  lead  to  inter- 
minable disputes,  without,  in  the  least,  tending  to  improve  in  practice.  This 
much,  however,  I  do  know  ;  both  diseases  are  developments  of  intermittent 
fever,  and  both  may  often  co-exist  at  one  and  the  same  time.  And  in  the 
Medical  Gazette  there  is  an  excellent  case  of  the  kind,  which,  as  it  in  a  great 
measure  illustrates  the  chrono-thermal  doctrine  and  treatment  in  both,  I  shall 
give  to  you  in  the  words  of  its  narrator: — "  The  patient's  symptoms  were 
difficult  respiration,  dry  cough  and  stringy  expectoration,  pulse  full.  The 
disease  commenced  with  an  intense  Jit  of  shivering,  followed  by  heat  and  a 
severe  cough.  Every  day  at  noon  tbere  was  an  exacerbation  of  all  the  symp- 
toms, commencing  with  very  great  shivering,  cough,  and  intolerable  pain  in 
the  chest,  a  fit  of  suffocation,  and  finally  a  perspiration  ;  at  the  end  of  an  hour 
the  paroxysm  terminated.  Ammoniacal  mixture  was  first  given,  then  two 
grains  of  quinine  every  two  hours.  The  very  next  day  the  fit  was  scarcely 
perceptible  ;  the  day  after,  there  was  no  fit  at  all.  An  observation  worthy 
of  remark  is,  that  the  symptoms  of  pleuro-pneumonia — which  continued 
throughout  in  a  very  slight  degree,  it  is  true,  in  the  intervals  of  the  par- 
oxysms— disappeared  completely,  and  in  a  very  short  time,  by  the  effect  of 
the  sulphate  of  quinine." 

Who  are  the  persons  most  suhject  to  inflammatory  disease  of  the  chest  ? 
Medical  theorists  answer,  "  strong  healthy  labourers,  and  people  much  ex- 
posed to  the  air."  How  these  gentlemen  deceive  themselves !  If  I  know 
anything  at  all  upon  any  subject,  I  know  that  the  fact  in  this  case  is  just  the 
reverse.  The  subjects  of  chest-disease  in  my  experience  have  been  almost 
all  persons  of  a  delicate  habit,  many  of  them  confined  to  badly-ventilated 
rooms,  and  the  greater  number  broken  down  hy  starvation,  blood-letting,  or 
previous  disease.  Some  of  you  may  have  heard  of  M.  Louis,  of  Paris,  a 
physician  who  for  many  years  has  made  chest-disease  his  study.  Speaking 
of  his  consumptive  patients,  who  became  the  subjects  of  inflammatory  disease, 
he  has  this  observation  : — "  As  we  have  already  remarked,  in  speaking  of 
Pneumonia,  the  invasion  of  Pleurisy  coincides  in  a  large  proportion  of  our 
patients  with  the  period  of  extreme  xoealcness  and  emaciation.'1'' — Dr.  Cowan's 
translation  of  Louis. 

Now,  what  is  the  usual  treatment  of  pleurisy  and  pneumonia  ?  Does  it 
not  almost  entirely  consist  in  blood-letting,  starving,  and  purging,  with  blisters 


82  LECTURE  IV. 

and  mercury  sometimes  ?  But  what  are  the  results  ?  relapse  or  repetition 
of  the  paroxysm  from  time  to  time,  long  illness,  weakness  ever  after,  and 
death  too  often.  Even  in  these  cases  of  extreme  emaciation,  M.  Louis  ap- 
plies leeches !  Contrast  the  case  I  have  just  given  you  from  the  Medical 
Gazette,  with  the  case  and  treatment  of  an  individual,  whose  omnipotent 
power  of  setting  a  theatre  in  a  roar  may  be  still  fresh  in  the  recollection  of 
many  of  you — the  celebrated  Joe  Grimaldi.  The  very  name  excites  your 
smile  !  but  upon  the  occasion  to  which  I  refer,  the  poor  clown,  instead  oJ 
being  in  a  vein  to  move  your  laughter,  very  much  wanted  your  sympathy. 
"  Monday,  the  9th  of  October,"  says  Mr.  Charles  Dickens,  "  was  the  day 
fixed  for  his  benefit,  but  on  the  preceding  Saturday,  he  was  suddenly  seized 
with  severe  illness,  originating  in  a  most  distressing  impediment  in  his  breath- 
ing. Medical  assistance  was  immediately  called  in,  and  he  was  bled  until 
nigh  fainting.  This  slightly  relieved  him,  but  shortly  after  he  had  a  relapse 
(return  of  the  paroxysm),  and  four  weeks  passed  before  he  recovered  suffici- 
ently to  leave  the  house.  There  is  no  doubt  (continues  Mr.  Dickens)  but 
that  some  radical  change  had  occurred  in  his  constitution ;  for,  previously, 
he  had  never  been  visited  with  a  single  day's  illness,  while,  after  its  occur- 
rence, he  never  had  a  single  day  of  perfect  health."  If  you  reflect  that 
medical  relief  was  immediately  called,  you  may  be  inclined,  like  myself,  to 
ascribe  poor.  Grimaldi's  damaged  constitution,  not  so  much  to  the  effect  of  the 
original  disorder,  as  to  the  sanguinary  treatment  adopted  in  his  case.  Whe- 
ther or  not  he  had  the  additional  medical  advantage  of  being  starved  at  the 
same  time,  I  do  not  know ;  but  lest  it  might  be  inferred  that  his  continued 
illness  was  owing  to  the  neglect  of  this  very  excellent  part  of  antiphlogistic 
practice,  I  may  just  hint,  that  there  have  been  such  things  as  inflammation 
of  the  lungs  brought  on  by  starvation.  Witness  the  verdict  of  a  coroner's 
jnry,  in  the  case  of  a  pauper,  who  died  not  long  ago  in  the  Whitechapel 
Workhouse.  "  That  the  deceased  died  from  inflammation  of  the  lungs, 
produced  by  exposure  and  want.''''  "The  verdict  in  question  was  only  in 
accordance  with  the  evidence  of  the  surgeon  of  the  workhouse. 

In  acute  disease  of  the  chest,  whether  involving  the  pleura  simply,  the 
interstitial  substances  of  the  lungs,  or  the  mucous  or  muscular  apparatus  of 
their  air-tubes,  your  first  duty  is  to  premise  an  emetic.  So  far  from  acting 
exclusively  on  the  stomach,  medicines  of  this  class  have  an  influence  primarily 
cerebral,  and  they,  therefore,  act  powerfully  upon  every  member  and  matter 
of  the  body.  By  emetics,  you  may  change  the  existing  relations  of  the 
whole  corporeal  atoms  more  rapidly  and  effectually  than  by  any  other  agency 
of  equal  safety  in  the  Materia  Medica.  Every  kind  of  chest-disease  being  a 
mere  feature  or  development  of  fever,  whatever  will  relieve  the  latter  will 
equally  relieve  the  former.  The  value  of  emetics  in  the  simpler  forms  of 
fever,  few  will  be  sufficiently  bold  to  deny  ;  and  the  quickness  with  which 
the  same  medicines  can  alter  the  state  of  an  inflamed  part  may  be  actually 
seen  by  their  effects  on  the  eye,  in  the  inflammatory  affections  of  that  organ 
You  have  only  to  try  them  "in  chest-disease,  to  be  satisfied  of  their  inesti 
mable  value  in  cases  of  this  kind.  Instead,  therefore,  of  talking  of  the  tem- 
porary good  you  have  occasionally  seen  done  by  the  lancet  in  inflammation 
of  the  chest,  call  to  mind  the  many  deaths  you  have  witnessed  where  it  had 
been  most  freely  used;  to  say  nothing  of  the  long  illnesses  which  have 
been  the  lot  of  such  as  have  escaped  the  united  bad  effect!  of  chest-disease 
and  loss  of  blood.  Whatever  salutary  influence  as  a  present  meant  of  relief, 
blood-letting  may  produce,  it  is  infinitely  Inferior  to  what  yon  may  obtain  by 
emetics — a  class  of  remedies  which  possess  tka  additional  advantage  of  giving 
that  relief,  without  depriving  the  patient  of  the  material  of  healthy  constitu- 
tional power.  Their  influence,  moreover*  M  a  preventive  against  return  ot 
the  paroxysm,  is  very  considerable;*  while  blood-letting,  so  far  as  my  ex- 

*  Thii  statement,  whan  I  flrst  published  it,  was  denied  by  physicians,  bat  Ithai  brrn  Rince  con  • 
Armed  by  Dr.  Seymour,  ofSt  George's  Hospital,  who  recently  made  tome  remarks  upon  the  jiower 
of  emetics  m  "  ultcriug  the  Vcrivduttij  il" 


LECTURE  IV.  83 

perience  goes,  lias  only,  on  the  contrary,  appeared  to  render  the  patient  more 
liahle  to  a  recurrence. 

Lord  Bacon  tell  us  in  his  works,  that  if  disciples  only  knew  their  own 
strength,  thev  would  soon  find  out  the  weakness  of  their  masters.  What 
led  him  to  this  conclusion  ?  What  but  the  fact,  that,  with  all  his  ability, 
even  he,  Lord  Bacon,  had  been  duped  by  his  teachers?  and  why  did  Des 
Cartes  say,  that  no  man  could  possibly  pretend  to  the  name  of  philosopher, 
who  had  not  at  least  once  in  his  life  doubted  all  he  had  been  previously 
taught  ?  He,  too,  had  been  hood-winked  by  his  pretended  masters  in  philo- 
sophy. But  you,  perhaps,  will  say  all  this  took  place  in  old  times — the  world 
is  quite  changed  since  then;  professois  are  now  the  most  enlightened  and 
respectable  men  alive  ;  they  go  to  church,  where  they  are  examples  of  piety  ; 
they  never  were  found  out  in  a  lie  ;  are  not  subject  to  the  passions  of  other 
men  ;  have  no  motives  of  interest  or  ambition  ;  in  fact,  they  are  all  but  angels. 
Now,  I  only  wish  you  knew  the  manner  in  which  most  of  these  very  respect- 
able persons  get  their  chairs — the  tricks,  the  party-work,  the  subserviency, 
meanness,  and  hypocrisy,  practised  by  them  for  that  and  other  ends — and 
you  would  not  so  tamely  submit  your  judgment  to  their  theoretic  dreams  and 
delusions.  Young  men,  be  men  ;  and  instead  of  taking  for  gospel  the  inco- 
herent and  inconsistent  doctrines  of  the  fallible  puppets,  whom  interest  or 
intrigue  has  stuck  up  in  academic  halls,  use  your  own  eyes,  and  exercise  your 
own  reason  !  Here,  then,  I  give  you  a  test,  by  which  you  may  know  the 
best  practice  in  inflammatory  diseases  of  the  chest — a  test  that  cannot  pos- 
sibly deceive  you.  Take  a  certain  number  of  pleuretic  and  pneumonic  pa- 
tients ;  bleed,  blister,  and  physic  these  after  the  most  orthodox  fashion;  so 
that  you  shall  not  be  able  to  tell,  whether  the  continued  disease  be  the  effect 
of  the  primary  cause,  or  the  heroic  measures  by  which  your  patients  have 
been  worried  during  their  illness.  Take  another  equal  number  similarly 
afflicted,  and  treat  them  chrouo-thermally  ;  that  is  to  say,  premise  an  emetic, 
and  when,  by  means  of  this,  you  have  obtained  a  remission  of  the  symptoms, 
endeavour  to  prolong  such  period  of  immunity,  by  quinine,  opium,  or  hydro- 
cyanic acid  ;  and  then  compare  the  results  of  both  modes  of  practice.  If  you 
do  not  find  an  immense  saving  of  suffering  and  mortality,  by  the  latter  mode 
of  treatment,  I  will  consent  to  be  stigmatised  by  you  as  an  impostor  and  de- 
ceiver, a  cheat,  a  quack,  a  person,  in  a  word,  who  would  rather  teach  error 
than  vindicate  truth.  Remember,  however,  before  you  begin,  that  the 
Chrono-Thermal  System  professes,  as  its  chief  feature  of  superiority  over 
every  other,  to  make  short  ivorlc  with  disease — a  circumstance  not  likely  to 
recommend  it  to  those  whose  emolument,  from  the  manner  in  which  things 
are  now  ordered,  arises  principally  from  long  sickness  and  much  physic ! 

I  am  often  asked  how  I  treat  Enteritis — Inflammation  of  the  Bowels — 
without  the  lancet  ?  Before  I  give  my  answer,  I  generally  ask — Can  medi- 
cal men  boast  of  any  particular  success  from  depletion  in  this  disease  ?  If 
so,  why  have  they  always  been'  so  solicitous  to  get  the  system  under  the 
influence  of  calomel — or  why  do  they  prescribe  turpentine  in  its  treatment  1 
Is  it  not  because  the  nature  of  the  relief  afforded  by  the  lancet  has  either  been 
temporary  or  delusive ;  or,  what  I  have  myself  found  it  to  be,  absolutely 
hurtful  in  the  majority  of  cases  ?  "  The  symptoms  of  Enteritis,"  says  Dr. 
Parr,  "  are  a  shivering,  with  an  uneasiness  in  the  bowels,  soon  increasing  to 
a  violent  pain — occasionally  at  first  remittent,  but  soon  becoming  continual. 
Generally,  the  whole  abdomen  is  affected  at  the  same  time  with  spasmodic 
pains,  which  extend  to  the  loins,  apparently  owing  to  flatulency.  The  pulse 
is  small,  frequent,  generally  soft,  but  sometimes  hard,  and  at  last  irregular 
and  intermittent ;  the  extremities  are  cold,  the  strength  sinks  rapidly." — 
"  Perhaps,"  he  adds,  u  bleeding  is  more  seldom  necessary  in  this  disease  than 
in  any  other  inflammation  ;  for  it  rapidly  tends  to  mortification,  and  should 
it  not"  at  once  relieve,  it  soon  proves  fatal."  In  a  letter  which  I  received  from 
Staff-Surgeon  Hume,  he  says  :  "  I  am  satisfied  that  Pneumonia  and  Enteritis, 


84  LECTURE  IV. 

diseases  which  are  at  present  the  bugbear  of  the  faculty,  ate  indebted  for  their 
chief  existence  to  the  remedies  employed  in  ordinary  ailments,  namely,  bleed- 
ing and  unnecessary  purging.  I  never  saw  a  case  of  either  (and  I  have 
seen  many)  of  which  the  subject  had  not  been  the  inmate  of  an  hospital  pre- 
viously, where  he  had  undergone  the  usual  '  antiphlogistic  regimen',  or  had 
been  otherwise  debilitated,  as  in  the  case  of  long  residence  in  a  warm  climate." 
Now,  Gentlemen,  this  is  the  language  of  an  experienced  medical  officer  in  the 
army,  one  who,  having  no  interested  end  to  serve,  and  who  would  not  take 
private  practice  if  offered  to  him,  is  at  least  as  worthy  of  belief  as  those  whose 
daily  bread  depends  upon  the  extent  and  duration  of  disease  around  them. 
My  own  practice  in  Enteritis,  I  will  illustrate  by  a  case.  I  was  one 
evening  requested  to  see  a  person  very  ill ;  I  found  him  with  severe 
pain  of  abdomen,  which  would  not  brook  the  touch,  furred  tongue,  hard 
pulse,  and  hot  skin ;  he  told  me  he  had  shivered  repeatedly,  that  the 
pain  was  at  first  intermittent,  but  at  last  constant.  He  had  been  seen  in  the 
morning  by  a  gentleman,  who  had  ordered  him  Turpentine  and  Calomel — a 
proof  that  he  also  considered  the  case  as  one  of  inflammation  of  the  bowels. 
The  patient  having  obtained  no  relief,  I  was  called  in.  I  gave  him  an 
emetic,  and  in  about  twenty  minutes  I  again  saw  him.  The  vomit  had  acted 
powerfully,  and  with  such  relief  that  he  could  then  turn  himself  in  bed  with 
ease,  which  he  could  not  before  do.  I  then  prescribed  prussic  acid  and 
quinine.  In  a  few  days  he  was  as  well  as  ever.  Instead  of  bringing  theo- 
retic objections  to  this  method  of  treating  inflammation  of  the  bowels,  let 
practitioners  only  put  it  to  the  proof.  Is  it  possible  that  they  can  be  less 
successful  with  the  new  practice  than  with  the  old,  under  which,  when  they 
save  a  patient  in  this  disease,  they  are  fain  to  boast  of  it  as  a  wonder  ! 
I  shall  now  enter  at  some  length  upon  the  subject  of 

Blood-Letting. 
While  with  one  class  of  practitioners,  Medicine  is  reduced  to  the  mere  art 
of  purgation,  with  another  class  it  consists  in  the  systematic  abstraction  of 
blood  ;  every  means  being  resorted  to  in  the  mode  of  doing  this,  from  vene- 
section, arteriotomy,  and  cupping,  to  the  basest  application  of  the  leech.  In 
the  remarks,  Gentlemen,  which  "I  am  about  to  make  on  the  subject,  instead 
of  discussing  the  preferable  mode  of  taking  blood  away,  I  shall  bring  before 
you  some  facts  and  arguments  that  may  convince  you  of  the  perfect  possi- 
bility of  dispensing  with  the  practice  altogether. 

"  The  imputation  of  novelty,"  says  Locke,  "is  a  terrible  charge  amongst 
those  who  judge  of  men's  heads  as  they  do  of  their  perukes,  by  the  fashion—  \ 
and  can  allow  none  to  be  right  but  the  received  doctrine."     Yet,  in  the  words 
of  the  same  acute  writer  :  "  An  error  is  not  the  better  for  being  common,  nor{ 
truth  the  worse  for  having  lain  neglected  ;  and  if  it  were  put  to  the  vote  anv-  / 
where  m  the  world,  I  doubt  as  things  are  managed,  whether  Truth  would  / 
have  *e  majority  ;  at  least  while  the  authority  of  men,  and  not  the  examina- 
tion of  things,  must  be  its  measure."     In  the  same  spirit,  Lord  Byron  asks  : 

"  What  from  tins  barren  being  do  we  reap  ?  ) 

Our  senses  narrow,  and  our  reason  frail, 

Life  short,  and  truth  a  gem  that  loves  the  deep, 

And  all  tilings  weighed  m  Ctulom's  falsest  scale. 

Opinion  an  omnipotence — whose  veil 

Mantles  the  earth  with  darkness— until  right 

And  wrong  are  accidents — and  men  grow  pale 

Lest  their  own  judgments  should  become  too  bright, 

And  their  free  thoughts  be  crimes,  ami  earth  bare  too  much  light!" 

The  operation  of  Blood-letting  is  so  associated,  in  the  minds  of  most  men, 

with  the  practice  of  physic,  that  when  a  very  sensible  Gorman   physician' 

some  time  ago,  petitioned  the  King  of  Prussia  to  make  the  employment  of 

the  lancet  penal,  he  was  laughed  at  from  one  end  of  Europe  to  the  other 


LECTURE  IV.  85 

This  you  will  not  wonder  at  if  you  consider  that  the  multitude  always  think 
"  whatever  is  is  right ;"  but  a  little  reflection  will  teach  you  that  there  must 
have  been  a  period  in  the  world's  history  when  the  lancet  was  unknown  as  a 
remedy  ;  and  that  many  centuries  necessarily  elapsed  before  it  could  even 
be  imagined  that  loss  of  blood  might  alleviate  or  cure  disease.  Nations, 
nevertheless,  grew  and  prospered.  To  what  daring  innovator  the  practice 
of  physic  owes  the  Curse  of  the  lancet,  the  annals  of  the  art  leave  us  in 
ignorance ;  but  this  we  know,  that  its  introduction  could  only  have  been 
during  the  infancy  of  Medicine,  when  remedial  means  were  yet  few,  and  the 
mode  of  action  of  remedies  totally  unknown.  It  was  the  invention  of  an  un- 
enlightened,— possibly,  a  sanguinary  age  ;  and  its  continued  use  says  but 
little  for  the  after-discoveries  of  ages,  or  for  the  boasted  progress  of  medical 
science. 

It  was  once  a  question  whether  or  not  the  blood  be  alive.  That  question 
is  now  definitely  settled.  John  Hunter,  to  the  conviction  of  everybody, 
proved  that  the  Blood  lives  ;  and  every  drop  that  artificially  leaves  the  sys- 
tem is  admitted,  even  by  those  who  take  it  awa}',  to  be  a  drop  of  life.  He 
who  loses  a  pint  of  blood  loses  a  pint  of  his  life.  Of  what  is  the  body  com- 
posed ?  Is  it  not  of  Blood,  and  Blood  only  ?  What  fills  up  the  excavation 
of  an  ulcer  or  an  abscess?  What  reproduces  the  bone  of  the  leg  or  thigh, 
after  it  has  been  thrown  off  dead,  in  nearly  all  its  length  ?  what  but  the  living 
Bloob,  under  the  vito-electrical  influence  of  the  Brain  and  Nerves  !  How 
does  the  slaughtered  animal  die  ?  Of  loss  of  blood  solely.  Is  not  the  blood, 
then,  in  the  impressive  language  of  Scripture,  "  the  life  of  the  flesh  ?"  How 
remarkable,  that  while  the  value  of  the  blood  to  the  animal  economy  should 
be  thus  so  distinctly  and  emphatically  acknowledged,  Blood-letting  is  not 
even  once  alluded  to,  among  the  various  modes  of  Cure  mentioned  in  the 
sacred  volume.  We  have  "balms,"  "balsams,"  "baths,"  "charms," 
"physics," — "poultices,"  even, — but  loss  of  blood,  never!  Had  it  been 
practised  by  the  Jews,  why  this  omission  ?  Will  the  men  who  now  so 
lavishly  pour  out  the  Blood,  dispute  its  importance  in  the  animal  economy? 
will  they  deny  that  it  forms  the  basis  of  the  solids?  that  when  the  body  has 
been  wasted  by  long  disease,  it  is  by  the  Blood  only  it  can  recover  its 
healthy  volume  and  appearance  ?  Has  not  nature  done  every  thing  to  pre- 
serve to  animals  of  every  kind, 

"The  electric  Blood  with  which  their  arteries  ran?" — Byron. 

She  has  provided  it  with  strong  resilient  vessels — vessels  which  slip  from  the 
touch,  and  never  permit  their  contents  to  escape,  except  where  their  coats 
have  been  injured  by  accident  or  disease.  Misguided  by  theory,  man,  pre- 
sumptuous man,  has  dared  to  divide  what  God,  as  a  part  of  creation,  united  ; 
to  open  what  the  Eternal,  in  the  wisdom  of  his  omniscience,  made  entire  ! 
See,  then,  what  an  extreme  measure  this  is  !  It  is  on  the  very  face  of  it  a 
most  unnatural  proceeding.  Yet  what  proceeding  so  common,  or  what  so 
readily  submitted  to,  under  the  influence  of  authority  and  custom  ?  If,  in 
the  language  of  the  Chemist  Liebig,  the  blood  be  indeed  "  the  sum  of  all 
the  organs  that  are  being  formed,"  how  can  you  withdraw  it  from  one 
organ  without  depriving  every  other  of  the  material  of  its  healthy  state  ? 
Yet  enter  the  crowded  hospitals  of  England — of  Europe — and  see  how  mer- 
cilessly the  lancet,  the  leech,  and  the  cupping-glass,  are  employed  in  the  dis- 
eases of  the  poor.  Look  at  the  pale  and  ghastly  faces  of  the  inmates.  What 
a  contrast  to  the  eager  pupils  and  attendants  thronging  around  their  beds — 
those  attendants  with  bandage  and  basin,  ready  at  a  moment's  notice  to  take 
from  the  poor  creatures  whatever  quantity  of  life-blood,  solemn  Pedantry  may 
prescribe  as  the  infallible  means  of  relieving  their  sufferings  !  Do  that,  I  say, 
and  refrain,  if  you  can,  from  exclaiming  with  Bulwer,  "when  Poverty  is 
sick,  the  doctors  mangle  it  !*'  What  are  the  causes  of  the  disorders  of  this 
class  of  people  ?  Inthe  majority  of  cases,  defective  food,  and  impure  air. 
By  these  has  their  blood  been  deteriorated — and  for  what  does  the  (so  termed) 


86  LECTURE  IV. 

man  of  science  abstract  it?  To  make  room  for  better  ?  No!  goaded  on  by  the 
twin-goblins,  "congestion"  and  "inflammation,"  to  deteriorate  it  still  further 
by  starvation  and  confinement.  Gentlemen,  these  terms  play  in  physic 
much  the  same  thing  as  others,  equally  senselessly  misused,  play  in  the  com- 
mon affairs  of  the  world — 

Religion,  Freedom,  Vengeance,  what  you  will, 

A  word's  enough  to  raise  mankind  to  kill, — 

Some  party-phrase  by  cunning  caught  and  spread, 

That  guilt  may  reign,  and  wolves  and  worms  be  fed! — Brrto.w 

The  first  resource  of  the  surgeon  is  the  lancet — the  first  thing  he  thinks  of 
when  called  to  an  accident  is,  how  he  can  most  quickly  open  the  flood-gates  of 
the  heart,  to  pour  out  the  stream  of  an  already  enfeebled  existence.  Does  a 
man  fall  from  his  horse  or  a  height,  is  he  not  instantly  bled  ? — has  he  been 
stunned  by  a  blow,  is  not  the  lancet  in  requisition  ?  Nay,  has  an  individual 
fainted  from  over-exertion  or  exhaustion,  is  it  not  a  case  of  fit — and  what  so 
proper  as  venesection  ! 

You  cannot  have  forgotten  the  fate  of  Malibran — the  inimitable  Malibran  ; 
she  who  so  often,  by  her  varied  and  admirable  performances,  moved  you  to 
tears  and  smiles  by  turns.  She  was  playing  her  part  upon  the  stage  ;  she  en- 
tered into  it  with  her  whole  soul,  riveting  the  audience  to  the  spot  by  the 
very  intensity  of  her  acting.  Just  as  she  had  taxed  the  powers  of  her  too 
delicate  frame  to  the  uttermost ;  at  the  very  moment  she  was  about  to  be  re- 
warded with  a  simultaneous  burst  of  acclamation,  she  fainted  and  fell ;  fell 
from  very  weakness.  Instantly  a  medical  man  leapt  upon  the  stage, — to  ad- 
minister a  cordial  ?  No — to  bleed  her !  to  bleed  a  weak,  worn,  and  ex- 
hausted woman  !  And  the  result  ?  she  never  rallied  from  that  unfortunate 
hour.  But,  Gentlemen,  Malibran  was  not  the  only  intellectual  person  of  the 
thousands  and  tens  of  thousands  who  have  prematurely  perished  by  the 
lancet.  Byron  and  Scott — those  master-spirits  of  their  age — those  great  men 
whq,  like  Ariosto  and  Shakspeare,  not  only  excited  the  admiration  of  tempo- 
rary millions,  but  whose  genius  must  continue,  for  generations  yet  unborn,  to 
delight  the  land  that  produced  them — they,  too,  fell  victims  to  the  lancet — 
they,  too,  were  destroyed  by  hands  which,  however  friendly  and  well-inten- 
tioned, most  undoubtedly  dealt  them  their  death-blows.  Is  not  this  a  subject 
for  deep  reflection  ?  To  the  cases  of  these  great  men  we  shall  recur  in  the 
course  of  this  lecture ;  but  for  the  present,  we  must  turn  to  other  matters — 
to  events  that  have  just  passed  before  our  eyes.  The  affair  of  Newport,  in 
Wales,  is  still  the  topic  of  the  hour.  You  must,  therefore,  remember  it  to  its 
minutest  detail — the  attack  by  the  rioters  upon  the  town — the  gallant  and 
successful  stand  made  by  Captain  Gray  and  his  little  detachment  of  the  35th 
regiment — the  prisoners  captured,  and  the  investigation  which  afterwards 
took  place.  In  the  course  of  that  inquiry,  a  prisoner,  when  under  examina- 
tion, fainted.  What  was  done  with  him  ?  he  was  carried  out  of  court  and 
immediately  bled  !  On  his  return,  the  newspapers  tell  us,  an  extraordinary 
change  had  come  over  his  countenance.  From  being  a  man  of  robust  ap- 
pearance, he  had  become  so  wan  and  haggard,  so  altered  in  every  lineament, 
the  spectators  could  scarcely  recognise  him  as  the  same  prisoner.  Ifet, 
6trange  to  say,  not  one  of  the  many  journals  that  reported  this  case,  intro- 
duced a  single  word  in  condemnation  of  the  utterly  uncalled-for  measure, 
which  brought  the  man  to  such  a  state ;  so  much  has  Custom  blunted  the 
sense  of  the  public  to  this  the  most  dangerous  of  all  medical  appliances  ! 

Gentlemen,  a  coroner's  inquest  was  held  upon  a  person  who  died  suddenly. 
I  shall  read  to  you  what  followed  from  the  Times  newspaper  of  the  20th 
December,  1839,  suppressing,  for  obvious  reasons,  the  name  of  tin-  witness. 

"  Mr. ,  surgeon,  stated  that  he  was  called  upon  to  attend  deceased, 

and  found  him  at  the  point  of  death.  He  attempted  to  iuuo  him,  but  in- 
effectually, and  in  less  than  a  minute  from  witness's  arrival,  deceased  expired. 
Witness  not  being  able  to  give  any  opinion  as  to  the  cause  of  death  from  the 


LECTURE  IV.  87 

symptoms  that  then  exhibited  themselves,  he  afterwards,  with  the  assistance 
of  Dr.  Ridge,  37,  Cavendish  Square,  made  a  post-mortem  examination,  and 
found  that  a  large  cavity  attached  to  the  large  vessel  of  the  heart,  containing 
blood,  had  burst,  and  that  that  was  the  cause  of  death."  So  that  while  the 
man  was  actually  dying  of  inanition  from  internal  bleeding,  the  surgeon, 
utterly  ignorant,  according  to  his  own  confession,  of  the  nature  of  the  symp- 
toms, deliberately  proceeded  to  open  a  vein  !  How  happens  it  that  the  lancet 
should  be  so  invariably  the  first  resort  of  Ignorance  ? 

In  every  case  of stun  or  faint,  the  employment  of  this  instrument  must  be 
a  superadded  injury ;  in  all,  there  is  a  positive  enfeeblement  of  the  whole 
frame,  evidenced  by  the  cold  surface  and  weak  or  imperceptible  pulse  ;  there 
is  an  exhaustion,  which  loss  of  blood,  so  far  from  relieving,  too  often  converts 
into  a  state  of  utter  and  hopeless  prostration.  True,  men  recover  though 
treated  in  this  manner  ;  but  these  are  not  Cures, — they  are  Escapes  ! 

How  few  the  diseases  which  loss  of  blood  may  not  of  itself  produce  !  If 
it  cannot  cause  the  eruptions  of  small-pox,  nor  the  glandular  swellings  of 
plague,  it  has  given  rise  to  disorders  more  frequently  and  more  immediately 
fatal  than  either.  What  think  you  of  cholera  asphyxia — Asiatic  cholera  ? 
Gentlemen,  the  symptoms  of  that  disease  are  the  identical  symptoms  of  a 
person  bleeding  sloivly  away  from  life  !  The  vomiting,  the  cramps,  the  sigh- 
ing, the  long  gasp  for  breath — the  leaden  and  livid  countenance  which  the 
painter  gives  to  the  dying  in  his  battle-pieces — these 'are  equally  the  symp- 
toms of  cholera  and  loss  of  blood  !  Among  the  numerous  diseases 
which  it  can  produce,  Darwin  says — "  a  paroxysm  of  gout  is  liable  to  recur 
on  bleeding."  John  Hunter  mentions  "  lock-jaw  and  dropsy,"  among  its  in- 
jurious effects, — Travers,  "  blindness,"  and  "  palsy," — Marshall  Hall, 
"  mania," — Blundell,  "  dysentery," — Broussais,  "  fever  and  convulsions  !" 
"  When  an  animal  loses  a  considerable  quantity  of  blood,"  says  John  Hunter, 
"  the  heart  increases  in  its  frequency  of  strokes,  as  also  in  its  violence."  Yet 
these  are  the  indications  for  which  professors  tell  you  to  bleed  !  You  must 
bleed  in  every  inflammation,  they  tell  you.  Yet  is  not  inflammation  a'  daily 
effect  of  loss  of  blood  ?  Magendie  mentions  '■'■pneumonia'''  as  having  been 
produced  by  it, — completely  confirming  the  evidence  of  Dr.  Hume  upon  that 
point.  He  further  tells  us  that  he  has  witnessed  among  its  effects,  "  the  en- 
tire train  of  what  people  are  pleased  to  call  inflammatory  phenomena  ;  and 
mark,"  he  says,  "  the  extraordinary  fact,  that  this  inflammation  will  have 
been  produced  by  the  very  agent  which  is  daily  used  to  combat  it !"  What 
a  long  dream  of  false  security  have  mankind  been  dreaming  !  they  have  laid 
themselves  down  on  the  laps  of  their  mentors, — they  have  slept  a  long  sleep  ; 
while  these,  like  the  fabled  vampire  of  the  poets,  taking  advantage  of  a  dark 
night  of  barbarism  and  ignorance,  have  thought  it  no  sin  to  rob  them  of  their 
life's  blood  during  the  profoundness  of  their  slumber ! 

Gentlemen,  the  long  shiver  of  the  severest  ague,  the  burning  fever,  the 
fatal  lock-jaw,  the  vomiting,  cramps,  and  asphyxia  of  cholera,  the  spasm  of 
asthma  and  epilepsy,  the  pains  of  rheumatism,  the  palpitating  and  tumultuous 
heart,  the  most  settled  melancholy  and  madness,  dysentery,  consumption, 
every  species  of  palsy,  the  faint  that  became  death,  these — all  these — have 
I  traced  to  loss  of  blood  !  Could  arsenic,  could  prussic  acid,  in  their  dead- 
liest and  most  concentrated  doses,  do  more  ?  Yet  I  have  heard  men  object 
to  use  the  minutest  portions  of  these  agents,  medicinally, — men  who  would 
open  a  vein,  and  let  the  life-blood  flow  until  the  patient  fell  like  an  ox  for 
the  slaughter,  death-like,  and  all  but  dead,  upon  the  floor  !  Do  these  prac- 
titioners know  the  nature  of  the  terrible  power  they  thus  fearlessly  call  to 
their  aid  ?  Can  they  explain  its  manner  of  action,  even  in  those  cases  where 
they  have  supposed  it  to  be  beneficial  ?  The  only  information  I  have  been 
able  to  extract  from  them  upon  this  point,  has  been  utterly  vague  and  value- 
loss.  Their  reasoning,  if  it  could  be  called  reasoning,  has  been  based  on  a 
dread  of  "  inflammation"  or  "  congestion."     From  the  manner  in  which  they 


88  LECTURE  IV. 

discuss  the  subject,  you  might  believe  there  was  no  remedy  for  either  but  the 
lancet.  Ask  them  why  they  bleed  in  ague — in  syncope — in  exhaustion  or 
collapse?  they  tell  you  it  is  to  relieve  congestion.  After  a  stun  or  fall?  it 
is  to  prevent  inflammation.  Bleeding,  in  all  my  experience,  I  have  already 
stated  to  you,  never  either  relieved  the  one,  or  prevented  the  other  !  Gen- 
tlemen, did  you  never  see  inflammation  of  a  vein  after  bleeding — inflamma- 
tion caused  by  the  very  act  ?  I  have  known  such  inflammation  end  fatally. 
Did  you  never  know  the  wounds  made  by  leech  bites  become  inflamed, 
after  these  reptiles  had  exhausted  the  blood  of  the  part  to  which  they  were 
applied  ?  And  how  came  that  about  ?  Simply  because,  however  perfectly 
you  exhaust  any  part  of  its  blood,  you  do  not  thereby  prevent  that  part  from 
being  again  filled  with  it — or  rattter,  you  make  it  more  liable  to  be  so,  by 
weakening  the  coats  of  the  containing  vessels!  Hundreds,  thousands,  have 
recovered  from  every  kind  of  disease,  who  never  were  bled  in  any  manner  ; 
and  many,  too  many  have  died,  for  whom  the  operation,  in  all  its  modes,  had 
been  most  scientifically  practised  !  Have  I  not  proved  that  every  remedial 
agent  possesses  but  one  kind  of  influence, — namely,  the  power  of  changing 
Temperature  ?  Let  the  schoolman  show  me  that  the  lancet  possesses  any 
superiority  in  this  respect — any  specific  influence  more  advantageous  than 
other  less  questionable  measures  ;  and  I  shall  be  the  last  to  repudiate  its  aid  in 
the  practice  of  my  profession.  The  beneficial  influence  of  blood-letting,  where 
it  has  been  beneficial  in  disease,  relates  solely  to  Temperature.  To  this  com- 
plexion it  comes  at  last,  and  to  nothing  more — the  equalisation  and  modera- 
tion of  Temperature.  In  the  congestive  and  non-congestive  stages  of  fever- 
the  cold — the  hot — the  sweating — the  lancet  has  had  its  advocates.  Blood- 
letting, under  each  of  these  circumstances,  has  changed  the  existing  temperature. 
Why,  then,  object  to  its  use  ?  For  this  best  of  reasons,  that  we  have  remedies 
without  number,  possessing  each  an  influence  equally  rapid,  and  an  agency 
equally  curative,  without  being,  like  blood-letting,  attended  with  the  insuperable 
disadvantage  of  abstracting  the  material  of  healthy  organisation.  I  deny  not  its 
power  as  a  remedy,  in  certain  cases ;  but  I  question  jts  claim  to  precedence,  even 
in  these.  Out  of  upwards  of  twelve  thousand  cases  of  disease  that  have, 
within  the  last  few  3'ears,  been  under  my  treatment,  I  have  not  been  com- 
pelled to  use  it  once.  Resorted  to,  under  the  most  favourable  circumstances, 
its  success  is  anything  but  sure,  and  its  failure  involves  consequences  which 
the  untoward  administration  of  other  means  may  not  so  certainly  produce. 
Have  we  not  seen  that  all  diseases  have  remissions,  and  exacerbations — that 
mania,  asthma,  apoplexy,  and  inflammation,  are  all  remittent  disorders !  From 
the  agony  or  intensity  of  each  of  these  developements  of  fever,  you  may  ob- 
tain a  temporary  relief  by  the  use  of  the  lancet ;  but  what  has  it  availed  in 
averting  the  recurrence  of  the  paroxysm  ?  How  often  do  you  find  the  patient 
you  have  bled  in  the  morning,  ere  night  with  every  symptom  in  aggravation  ! 
Again  you  resort  to  bleeding,  but  the  relief  is  as  transitory  as  before.  True, 
you  may  repeat  the  operation,  and  re-repeat  it,  until  you  bleed  both  the  blood 
and  the  life  away.  Venesection,  then,  in  some  cases,  may  be  a  temporary, 
though  too  often  a  delusive,  relief.  The  general  result  is  depression  of  vital 
energy,  with  diminution  of  corporeal  force  ! 

Dr.  Southwood  Smith,  physician  to  the  London  Fever  Hospital,  published 
a  book  purposely  to  show  the  advantages  of  bleeding  in  fever.  One  of  his 
cases  is  so  curiously  illustrative,  of  his  position,  1  .shall  take  the  liberty 
of  transcribing  it  from  the  Medical  Qazettif  with  a  running  commentary  by 
the  editor  of  that  periodical : — "  The  case  of  Dr.  Dill  demands  our  most 
serious  attention,  and  deserves  that  of  our  readers.  It  is  adduced  u  an  ex- 
ample of  severe  cerebral  affection,  in  which  case.  Dr.  S.  affin&e,  '  the  bleed- 
ing must:  be  large  and  early  as  it  is  copious.'  , '  1  saw  him.'  says  Dr.  Smith, 
1  /"■/;-/-,  there  was  any  pain  in  the  bead,  or  even  in  the  back,  while /m  was  yet 
only  feeble  mid  chilly.  The  aspect  of  bis  countenance,  the  state  of  his  pulse, 
which  was  slow  and  labouring,  mid  the  answer  be  returned  to  two  or  three 


LECTURE  FT.  89 

questions,  satisfied  me  of  the  inordinate,  I  may  say,  the  ferocious  attack  that 
was  at  hand.— P.  398.' 

Whatever  may  be  the  opinion  of  our  readers,  as  to  the  above  signs  indi- 
cating a  ferocious  cerebral  attack,  they  will  one  and  all  agree  with  us,  that 
the  ferocious  attack  was  met  with  a  ferocious  treatment;  for  an  emetic  was 
given  without  delay,  and  '  blood  was  taken  from  the  arm,  to  the  extent  of 
twenty  ounces.''  This  blood  was  not  inflamed.  Severe  pains  in  the  limbs  and 
loins,  and  intense  pain  in  the  head,  came  on  during  the  night,  and  early  in 
the  morning,  blood  was  again  drawn  to  the  extent  of  sixteen  ounces,  '  with 
great  diminution,  but  not  entire  removal  of  the  pain.'  Towards  the  afternoon, 
he  was  again  bled  to  sixteen  ounces.  '  The  pain  was  now  quite  gone — the 
blood  from  both  these  bleedings  intensely  inflamed.''  [Inflamed,  according  to 
Dr.  Smith's  notions — but  mark,  in  his  own  words — the  first  blood  drawn  was 
'  not  inflamed.'  Were  the  lancet  a  preventive  of  inflammation,  how  came 
the  blood  to  be  inflamed  after  so  many  bleedings?] 

"  During  the  night  the  pain  returned,  and  in  the  morning,  notwithstanding 
the  eyes  were  dull,  and  beginning  to  be  suffused,  the  face  blanched  (no  won- 
der !)  and  the  pulse  slow  and  intermittent,  and  weak,  twelve  leeches  were  ap- 
plied to  the  temples ;  and  as  these  did  not  entirely  remove  the  pain,  more 
blood,  to  the  extent  of  sixteen  ounces,  was  taken  by  cupping.  The  opera- 
tion afforded  great  relief;  but  the  following  morning,  the  pain  returned, 
and  again  was  blood  extracted  to  the  amount  of  sixteen  ounces.  '  Immediate 
relief  followed  this  second  operation;  but.  unfortunately,  the  pain  returned 
with  great  violence,  towards  evening ;  and  it  was  now  impossible  to  carry 
the  bleeding  any  further.  Typhoid  symptoms  now  began  to  show  them- 
selves :  '  the  fur  on  the  tongue  was  becoming  brown,  and  there  was  already 
slight  tremor  in  the  hands.'  What  was  to  be  done  ?  Ice,  and  evaporating 
lotions  were  of  no  avail ;  but  happily  for  Dr.  Dill,  the  affusion  of  cold  water 
on  the  head,  '  the  cold  dash,'  was  thought  of  and  employed  ;  and  this  being 
effectually  applied,  the  relief  was  'instantaneous  and  most  complete.'  So 
that  this  case,  announced  as  a  severe  cerebral  affection,  and  treated,  in  anti- 
cipation, by  copious  blood-letting,  before  there  was  any  pain  in  the  head, 
while  the  patient  was  yet  only  feeble  and  chilly,  which  grew  worse  and  worse 
as  the  blood-letting  was  repeated,  until,  after  the  abstraction  of  ninety  ounces 
of  blood,  the  patient  had  become  in  a  state  of '  intense  suffering'  and  '  immi- 
nent danger,'  and  was  relieved  at  last  by  the  cold  dash — this  case,  we  say.  is 
brought  forward  as  a  specimen  of  the  extent  to  which  copious  blood-letting 
may  sometimes  be  required  !  !  Most  sincerely  do  we  congratulate  Dr. 
Dill  on  his  escape,  not  from  dangerous  disease,  but  from  a  dangerous  re- 
medy."— Medical  Gazette. 

What  could  more  completely  exemplify  the  utter  inefficiency  of  blood- 
letting, in  almost  all  its  forms,  either  as  a  certain  remedy,  or  a  preventive  of 
fever  ?  Yet  such  is  the  force  of  custom,  prejudice,  education,  that  this  case 
— and  I  have  no  doubt,  thousands  like  it — so  far  from  opening  the  eyes  of  the 
physician  to  the  London  Fever  Hospital,  only  served  to  confirm  him  in  his 
error.  He  had  his  methodus  medendi,  and  he  pursued  it ;  and  notwithstand- 
ing the  total  failure  of  his  vaunted  remedy,  he  gives  the  case  at  length,  as  a 
perfect  specimen  of  the  most  perfect  practice.  Mark  the  result  of  that  prac- 
tice !  but  for  the  "cold  dash,"  the  patient  must  have  perished.  It  is  even 
now  a  question,  whether  he  ever  recovered  from  those  repeated  blood-lettings, 
for  he  died  not  many  months  after.  Happy  would  it  have  been  for  mankind, 
that  we  had  never  heard  of  a  "  Pathological  School ;"  happier  for  Dr.  Dill, 
for  to  that  school  and  its  pervading  error  of  imputing  effect  for  cause — of 
arguing  from  the  end  as  if  it  were  the  beginning — may  we  fairly  attribute  all 
this  sanguinary  practice. 

Lord  Byron  called  medicine  "  the  destructive  art  of  healing."  How  truly 
it  proved  to  be  so  in  his  own  person,  you  shall  see,  when  1  give  you  the  de- 
tails of  his  last  illness : — "  Of  all  his  prejudices,"  says  Mr.  Moore,  "  he 


90  LECTURE   IV. 

declared  the  strongest  was  that  against  bleeding.  Kis  mother  had  obtained 
from  him  a  promise,  never  to  consent  to  be  bled ;  and,  whatever  argument 
might  be  produced,  his  aversion,  he  said,  was  stronger  than  reason.  '  Be- 
sides, is  it  not,'  he  asked,  '  asserted  by  Dr.  Reid,  in  his  Essays,  that  less 
slaughter  is  effected  bv  the  lance,  than  the  lancet — that  minute  instrument 
of  mighty  mischief!'  "On  Mr.  Millengen  observing,  that  this  remark,  related 
to  the  treatment  of  nervous,  but  not  of  inflammatory  complaints,  he  rejoined, 
in  an  angry  tone,  '  Who  is  nervous  if  I  am  not  ?  and  do  not  those  other 
words  of  his  (Dr.  Reid's)  apply  to  my  case,  where  he  says,  that  drawing  blood 
from  a  nervous  patient,  is  like  loosening  the  cords  of  a  musical  instrument, 
whose  tones  already  fail  for  want  of  sufficient  tension  !  Even  before  this 
illness,  you  yourself  knew  how  weak  and  irritable  I  had  become  ;  and  bleed- 
ing, by  increasing  this  state,  will  inevitably  kill  me.  Do  with  me  what  else 
you  like,  but  bleed  me  you  shall  not.  I  have  had  several  inflammatory  fevers 
in  my  life,  and  at  an  age  when  more  robust  and  plethoric;  yet  I  got  tit  rough 
them  without  bleeding.  This  time,  also,  will  I  take  my  chance.'  "  After 
much  reasoning,  and  repeated  entreaties,  Mr.  Millengen  at  length  succeeded 
in  obtaining  from  him  a  promise,  that  should  he  feel  his  fever  increase*  at  night, 
he  would  allow  Dr.  Bruno  to  bleed  him.  "  On  revisiting  the  patient  early 
next  morning,  Mr.  Millengen  learned  from  him,  that  having  passed,  as  he 
thought,  on  the  whole,  a  better  night,  he  had  not  considered  it  necessary  to 
ask  Dr.  Bruno  to  bleed  him.  What  followed,  I  shall,  in  justice  to  Mr. 
Millengen,  give  in  his  own  words : — "  I  thought  it  my  duty  now  to  put 
aside  all  consideration  of  his  feelings,  and  to  declare  solemnly  to  him 
how  deeply  I  lamented  to  see  him  trifle  thus  with  his  life,  and  show 
so  little  resolution.  His  pertinacious  refusal  had  alread}r,  I  said,  caused 
much  precious  time  to  be  lost;  but  few  hours  of  hope  now  remained; 
and,  unless  he  submitted  immediately  to  be  bled,  we  could  not  answer 
for  the  consequences.  It  was  trufe,  he  cared  not  for  life,  but  who  could 
assure  him,  that,  unless  he  changed  his  resolution,  the  uncontrolled 
disease  might  not  operate  such  disorganisation  in  his  system,  as  utterly  and 
for  ever  to  deprive  him  of  reason  !  I  had  now  hit  at  last  on  the  sensible 
chord  ;  and  partly  annoyed  by  our  importunities,  partly  persuaded,  he  cast  at 
us  both  the  fiercest  glance  of  vexation,  and  throwing  out  his  arm,  said,  in  the 
angriest  tone,  '  There  you  are,  I  see,  a  d — d  set  of  butchers, — take  away  as 
much  blood  as  you  like,  but  have  done  with  it !'  We  seized  the  moment, 
(adds  Mr.  Millengen,)  and  drew  about  twenty  ounces.  On  coagulation,  the 
blood  presented  a  strong  buffy  coat ;  yet  the  relief  obtained  did  not  corres- 
pond to  the  hopes  we  had  formed  ;  and  during  the  night  the  fever  became 
stronger  than  it  had  been  hitherto,  the  restlessness  and  agitation  in- 
creased, and  the  patient  spoke  several  times  in  an  incoherent  manner.'  " 
Surely  this  was  sufficient  to  convince  the  most  school-bound  of  the  worse 
than  inoperative  nature  of  the  measure.  Far  from  it.  "  On  the  following 
morning,  the  17th  April,  the  bleeding  was  repeated  tuice,  and  it  was  thought 
right  also  to  apply  blisters  to  the  soles  of  his  feet  !"  Well  might  Mr.  Moore 
exclaim,  "  It  is  painful  to  dwell  on  such  details."  For  our  present  purpose,  it 
will  be  sufficient  to  state,  that  although  the  "  rheumatic  symptoms  hail  been 
completely  removed,"  it  was  at  the  expense  of  the  patient's  life  ;  his  death 
took  place  upon  the  19th,  that  is,  three  days  after  he  was  first  bled. — [Moure's 
Life  of  Byron.]  Now  I  ask  you,  what  might  have  been  the  termination  of 
this  case,  had  an  emetic  been  substituted  for  the  lancet,  and  hud  the  remis- 
sion been  prolonged  by  quinine,  opium,  or  arsenic  !  I  solemnly  believe  Lord 
Byron  would  be  alive  at  this  moment;  nay,  not  only  is  it  possible,  but  pro- 
bable, that  a  successful  result  might  have  ensued,  without  any  treatment  at  all. 
When  describing  the  effects  of  a  Former  fever.  Lord  Byron  himself  saysi 
"  After  a  week  of  half  delirium,  burning  shin,  thirst,  hot  headache,  horrible 
pulsation,  and  no  sleep,  by  the  blessings  of  barley-water,  and  refusing  to  see 
zny  physician,  I  recovered."     Facts  like  these  are  indeed  -tubbom  things! 


LECTURE  IV.  91 

_  I  have  preferred  to  give  these  two  instances  of  what  I  conceive  to  be  de- 
cided malpractice,  to  any  of  the  numerous  cases  which  have  come  under  my 
own  observation,  as  the  first-named  gentleman  was  well  known  to  many  of 
the  medical  profession,  while  the  death-scene  of  the  noble  poet  will  arrest  the 
attention  of  all  who  take  an  interest  in  his  genius. 

In  the  generality  of  cases  of  disease,  Gentlemen,  it  matters  little  what  may 
have  been  the  primary  Cause.  The  disease  or  effect,  under  every  circum- 
stance, not  only  involves  change  of  temperature,  but  produces  more  or  less 
interruption  to  the  two  vital  processes,  Digestion  and  Respiration.  In  other 
■words,  it  impedes  sanguification,  or  the  necessary  reproduction  of  that 
living  fluid,  which  throughout  all  the  changes  of  life  is  constantly  maintain- 
ing expenditure.  This  being  in  the  nature  of  things  one  of  the  first  effects  of 
disorder,  let  us  beware  how  we  employ  a  remedy,  which,  if  it  succeed  not  in  re- 
storing healthy  temperature,  must  inevitably  hasten  the  fatal  catastrophe — or, 
in  default  of  that,  produce  those  low  chronic  fevers,  which,  under  the  names 
of  dyspepsia,  hypochondria,  hysteria,  mania,  &c,  the  best  devised  means  too 
often  fail  to  alleviate,  far  less"  to  cure.  With  the  free  admission,  then,  that 
the  lancet  is  capable  of  giving  temporary  relief  to  local  fulness  of  blood,  and 
to  some  of  the  attendant  symptoms,  I  reject  it  generally,  upon  this  simple  and 
rational  ground,  that  it  cannot  prevent  such  fulness  from  returning — while  it 
requires  no  ghost  from  the  grave  to  tell  us  that  its  influence  upon  the  general 
constitution  must,  in  every  such  case,  be  prejudicial.  If  the  source  of  a 
man's  income  is  suddenly  cut  off,  and  he  still  continue  to  spend  as  before, 
surely  his  capital  must,  as  a  matter  of  course,  diminish.  Beware  then,  how, 
tinder  the  exact  same  circumstances  of  body,  you  allow  a  doctor  to  take  away 
the  little  capital  of  blood  you  possess  when  disease  comes  upon  you, — re- 
member there  is  then  no  income — all  is  expenditure.  And  I  care  not  whether 
you  take  inflammation  of  any  considerable  internal  organ, — the  Brain,  Liver, 
or  Heart,  for  example, — or  of  any  external  part,  such  as  the  knee  or  ankle- 
joint — with  the  lancet,  you  can  seldom  ever  do  more  than  give  a  delusive  re- 
lief, at  the  expense  of  the  powers  of  the  constitution.  The  man  of  routine, 
who  has  not  heard  my  previous  lectures,  giving  up  Fever,  perhaps,  and  a 
few  other  disorders,  which  the  occasional  obstinacy  of  a  refractory  patient, 
contrary  to  "  received  doctrine,"  has  taught  him  may  yield  to  other  means 
than  blood-letting — will  ask  me  what  I  should  do  without  the  lancet  in  Apo- 
plexy ?  Here  the  patient  having  no  will  of  his  own,  and  the  prejudices  of 
his  friends  being  all  in  favour  of  blood-letting,  the  school-bound  member  of 
the  profession  has  seldom  an  opportunity  of  opening  his  eyes.  Mine  were 
opened  by  observing  the  want  of  success  attending  the  sanguinary  treatment ; 
in  other  words,  the  number  of  deaths  that  took  place,  either  in  consequence, 
or  in  spite  of  it.  Was  not  that  a  reason  for  change  of  practice  ?  Having  in 
my  Military  Hospital  no  prejudice  to  combat,  and  observing  the  flushed  and 
hot  state  of  the  patient's  forehead  and  face,  I  determined  to  try  the  cold  dash. 
The  result  was  beyond  my  best  expectations.  The  first  patient  was  laid  out 
all  his  length,  and  cold  water  poured  on  his  head,  from  a  height.  After  a 
few  ablutions,  he  staggered  to  his  feet,  stared  wildly  round  him,  then  walked 
to  the  hospital,  where  an  aperient  completed  his  cure.  While  in  the  army, 
I  had  a  sufficiently  extensive  field  for  my  experiments ;  and  I  seldom  after- 
wards lost  an  apoplectic  patient. 

But,  Gentlemen,  since  I  embarked  in  private  practice,  I  have  improved 
upon  my  Army  plan.  With  the  aperient  given  after  the  cold  dash,  I  have 
generally  combined  quinine  or  arsenic — and  I  have  also,  upon  some  occasions, 
at  once  prescribed  hydrocyanic  acid  without  any  aperient  at  all.  This  prac- 
tice I  have  found  highly  successful.  That  Quinine  may  prevent  the  apo- 
plectic fit,  I  have  proved  to  you,  by  the  case  given  by  Dr.  Graves.  The 
value  of  Arsenic  in  Apoplexy  has  also  been  acknowledged,  by  members  of 
the  profession  ;  but  whether  they  have  been  acquainted  with  the  true  prin- 
ciple of  its  mode  of  action,  in  such  cases,  is  another  thing.     Dr.  A.  T.  Thorn- 


92  LECTURE  IV. 

son  recommends  it  "  in  threatened  apoplexy',  after  Cuppings  and  Purgings, 
when  the  strength  is  diminished  and  the  complexion  pale  ;"  that  is,  you  must 
first  break  down  the  whole  frame  by  depletion— you  must  still  further  weaken 
the  already  weak  vessels  of  the  brain,  before  you  take  measures  to  give  their 
coats  the  degree  of  strength  and  stability  necessary  to  their  healthy  contain- 
ing power  !  Upon  what  principle  would  you,  Gentlemen,  prescribe  arsenic 
in  threatened  Apoplexy  ?  Surely  upon  the  same  principle  that  you  would 
prescribe  it  during  the  remission  in  ague — to  prolong  the  period  of  immunity 
— to  avert  the  paroxysm.  Long  after  the  Peruvian  Bark  came  into  fashion 
for  the  cure  of  Ague,  practitioners  still  continued  to  treat  that  distemper,  in 
the  first  instance,  by  depletion,  till  the  complexion  became  pale.  Do  they 
treat  it  so  now  ?  No  !  Why,  then,  do  they  go  on  from  day  to  day,  bleed- 
ing in  threatened  Apoplexy  ?  In  the  ca3e  given  by  Dr.  Graves,  depletion, — 
repeated  depletion,  did  not  prevent  the  recurrence  of  the  apoplectic  fit — but 
Quinine  was  at  once  successful.  Sir  Walter  Scott  had  a  series  of  fits  of 
Apoplexy.  What  did  the  bleeding  and  starving  system  avail  in  his  case? 
It  gave  him,  perhaps,  a  temporary  relief,  to  leave  him  at  last  in  a  state  of 
irrecoverable  prostration.  Mr.  Lockhart,  his  biographer,  tells  us  how  weak 
the  bleeding  always  made  him.  But  how  could  it  be  otherwise,  seeing  that 
I  have  proved  to" all  but  mathematical  demonstration,  that  whatever  debili- 
tates the  whole  bodv,  must  still  further  confirm  the  original  weakly  condition 
of  the  coats  of  the  blood-vessels,  which  constitutes  the  tendency  to  apoplexy  ? 
Had  the  cold  dash  been  resorted  to  during  the  fit,  and  had  quinine,  arsenic, 
or  hydrocyanic  acid  been  given  during  the  period  of  immunity,  wdio  knows 
but  the  Author  of  Waverley  might  still  be  delighting  the  world  with  the 
wonderful  productions  of  his  pen  ! 

Shall  I  be  told  there  are  cases  of  Apoplexy,  where  the  face  is  pale,  and  the 
temperature  cold  ?  My  answer  is — these  are  not  Apoplexy,  but  Faint ;  cases 
which,  with  the  cold  dash  or  a  cordial,  might  recover,  but  which  the  lancet,  in 
too  many  instances,  has  perpetuated  to  fatality  !  If  the  practitioner  tells  me 
that  the  cold  dash  by  no  possibility  can  cure  an  Apoplexy,  where  a  vessel  is 
ruptured  with  much  effusion  of  blood  on  the  brain  ;  my  reply  is,  that  in  such  a 
case  he  may  bleed  all  the  blood  from  the  body,  with  the  same  unsuccessful 
result!  In  the  case  of  effusion  of  blood  in  an  external  part,  from  a  bruise  for 
instance,  could  any  repetition  of  venesection  make  the  effused  blood  re-enter 
the  vessel  from  which  it  had  escaped  ?  No  more  could  it  do  so  in  the  brain, 
or  any  other  part.  Why,  then,  resort  to  it  in  this  case  ?  If  it  be  said  to 
stop  the  bleeding,  I  answer,  that  it  has  no  such  power.  Who  will  doubt  that 
cold  has?  Surely,  if  the  mere  application  of  a  cold  key  to  the  back  very 
often  stops  bleeding  from  the  nose,  you  can  be  at  no  loss  to  conceive  how  the 
far  greater  shock  of  the  cold  dash  may  stop  a  bleeding  in  the  brain  !  When, 
on  the  contrary,  there  is  no  vascular  rupture,  but  only  a  tendency  to  it,  the 
cold  dash  will  not  only  contract  and  strengthen  the  vascular  coats,  so  as  to 
prevent  them  from  giving  way,  but  will,  moreover,  rouse  the  patient  from  his 
stupor,  by  the  simple  shock  of  its  application.  But  from  theory  and  hypo- 
thesis, I  appeal  to  indubitable  and  demonstrative  fact.* 

Let  the  older  members  of  the  profession  seriously  reflect  upon  the  ultimate 
injury  which  may  accrue  to  their  own  interests,  by  opposing  their  sehool  fol- 
lies and  school  prejudices  to  palpable  and  demonstrative  truth.  So  lOBg  as 
colleges  and  schools  could  mystify  disease  and  its  nature,  any  treatment  that 

*  M.  Copomnn,  in  1845,  gives  the  statistics  of  the  bleeding  and  non-Mrnlinr  practice  i:i   \i 

In  1836,  when  I  first  repudiated  tlm  lancet  in  tin,  .li-1-n^.r,  the  itatiatic*  were  all me  ride,  the  only 

ol  the  Ma-bleeding  sideofthe  argument  being  my  own.    The  following  in  from  Mr.  Copeatan'l 
table:— 

Number  bled,     ...    128  Cured,    ...    51  Died, 

Number  not  bled,   .     .      36  Cured,     ...     18  Died, 

■hewing  that  in  the  caiei  when-  bleeding  wai  practiaed  nearly  two  out  of  three  died  \  a  bereaa  in  the 

treated  without  II l-letting,  more  than  two  out  ef  three  recovered!     What  is  the  worth  of 

general  aaaerttor.i  in  tin:  (ace  of  each  evidence  1 


LECTURE  IV.  93 

these  proposed — no  matter  how  cruel  or  atrocious — would  be  submitted  to  in 
silence  ;  but  when  people  find  out  that  every  kind  of  disorder,  inflammation 
included,  may  be  conquered,  not  only  by  external  but  by  internal  means,  they 
will  pause  before  they  allow  themselves  to  be  depleted  to  death,  or  all  but 
death,  by  the  lancet  of  either  surgeon  or  physician.  The  world  will  not  now 
be  deluded  by  the  opposition  of  men  who  stick  to  their  opinion,  not  so  much 
because  they  have  long  supported  it,  as  that  it  supports  them ;  men 
who,  in  the  words  of  Lord  Bacon,  would  dispute  with  you  whether  two 
and  txoo  make  four,  if  they  found  the  admission  to  interfere  with  their 
interests. 

Will  any  practitioner  be  so  bold  as  to  tell  me  that  inflammation  of  any 
organ  in  the  body  is  beyond  the-  control  of  internal  remedies  ?  For  what, 
then,  I  ask,  do  we  prescribe  mercury  for  inflammation  of  the  liver  and  bowels  ? 
Why  do  we  give  colchicum  for  the  inflamed  joints  termed  gout  and  rheum- 
atism ?  Do  not  these  remedies,  in  numerous  instances,  lessen  the  tempera- 
ture, pain,  and  morbid  volume  of  these  inflammations,  more  surely  and  safely 
than  the  application  of  leech  or  lancet?  If,  for  such  inflammation,  then,  we 
have  influential  internal  remedies,  why  may  we  not  have  medicines  equally 
available  for  diseases  of  the  lungs  ?  Have  I  not  shown  you  the  value  of 
prussic  acid  in  such  cases  ?  But  I  shall  be  told  of  the  danger  of  such  a 
remedy  in  any  but  skilful  hands.  In  the  hands  of  the  ignorant  and  injudi- 
cious, what  remedial  means,  let  me  ask,  have  not  proved,  not  only  dangerous, 
but  deadly  ?  Has  not  mercury  done  so ?  A.re  purgatives  guiltless?  How 
many  have  fallen  victims  to  the  lancet  ?  With  prussic  acid,  properly  diluted 
and  combined,  I  have  saved  the  infant  at  the  breast  from  the  threatened  suf- 
focation of  croup  ;  and  I  have  known  it  in  the  briefest  space  of  time  relieve 
so-called  inflammation  of  the  lungs,  where  the  previous  pain  and  difficulty  of 
breathing  were  hourly  expected  to  terminate  in  death.  True,  like  every 
other  remedy,  it  may  fail ;  but  have  we  no  other  means,  or  -combination  of 
means  for  such  cases  1  With  emetics  and  quinine,  I  have  seldom  been 
at  a  loss ;  and  with  mercury  and  turpentine,  I  have  cured  pneumonia. 

But  will  the  inflamed  heart  yield  to  anything  but  blood-letting  ?  Fearlessly 
I  answer  yes  !  and  with  much  more  certainty.  With  emetics,  prussic  acid, 
mercury,  colchicum,  silver,  &c,  I  have  conquered  cases  that  were  theoreti- 
cally called  inflammations  of  the  heart,  and  which  the  abstraction  of  half  the 
blood  in  the  body  could  not  have  cured.  So  also  has  Dr.  Fosbroke,  physician 
to  the  Ross  Dispensary,  a  gentleman  who  had  the  felicity  to  be  associated 
with  Dr.  Jenner  in  his  labours,  and  one  in  whose  success  and  fortunes  that 
illustrious  man  took  the  warmest  interest.  [See  Baron's  Life  of  Jenner.]  In 
some  of  the  numbers  of  the  Lancet,  Dr.  Fosbroke  has  given  several  cases  of 
heart-disease,  which  he  treated  successfully  without  blood-letting  ;  and  with 
a  rare  candour  he  admits,  that  a  lecture  of  mine  on  the  heart  and  circulation 
had  no  small  influence  in  leading  him  to  dismiss  blood-letting  in  the  treatment 
of  them. 

The  human  mind  does  not  easily  turn  from  errors  with  which,  by  early 
education,  it  has  been  long  imbued  ;  and  men,  grey  with  years  and  practice, 
seldom  question  a  custom  that,  fortunately  for  them  at  least,  has  fallen  in  with 
the  prejudices  of  their  times.  For  myself,  it  was  only  step  by  step,  and  that 
slowly,  that  I  came  to  abandon  the  lancet  altogether  in  the  treatment  of  dis- 
ease. My  principal  substitutes  have  been  the  various  remedies  which,  from 
time  to  time,  I  have  had  occasion  to  mention ;  but  in  a  future  lecture  I 
shall  again  enter  more  fully  into  their  manner  of  action.  That  none  of  them 
are  without  danger  in  the  hands  of  the  unskilful,  I  admit;  nay,  that  some  of 
them,  mercury  and  purgatives,  for  example,  have,  from  their  abuse,  sent  many 
more  to  the  grave  than  they  ever  saved  from  it,  is  allowed  by  every  candid 
and  sensible  practitioner.  But  that  was  not  the  fault  of  the  medicines,  but  of 
the  men,  who,  having  prescribed  them  without  properly  understanding  the 
principles  of  their  action,  in  the  language  of  Dr.  Johnson,  "  put  bodies  of  which 
they  knew  little,  into  bodies  of  which  they  knew  less !" 


94  LECTURE  IV. 

Gentlemen,  I  have  not  always  had  this  horror  of  blood-letting.  In  many 
instances  have  I  formerly  used  the  lancet,  where  a  cure,  in  my  present  state 
of  knowledge,  could  have  been  effected  without :  but  this  was  in  my  noviciate, 
influenced  by  others,  and  without  sufficient  or  correct  data  to  think  for  my- 
self. In  the  Army  Hospitals,  I  had  an  opportnnity  of  studying  disease,  both 
at  home  and  abroad.  There  I  saw  the  fine  tall  soldier,  on  his  first  admission, 
bled  to  relief  of  a  symptom,  or  to  fainting.  And  what  is  fainting  ?  A  loss  of 
every  organic  perception — a  death-like  state,  which  only  differs  from  death 
by  the  possibility  of  recall.  Prolong  it  to  permanency,  and  it  is  death. 
Primary  symptoms  were,  of  course,  got  over  by  such  measures  ;  but  once 
having  entered  the  hospital  walls,  I  found  that  soldier's  face  become  familiar 
to  me.  Seldom  did  his  pale  countenance  recover  its  former  healthy  character. 
He  became  the  victim  of  consumption,  dysentery,  or  dropsy  ;  his  constitu- 
tion was  broken  by  the  first  depletory  measures  to  which  he  had  been 
subjected. 

Such  instances,  too  numerous  to  escape  my  observation,  naturally  led  me  to 
ask — Can  this  be  the  proper  practice  ?  It  was  assuredly  the  practice  of  others 
—of  all.  Could  all  be  wrong  ?  Reflection  taught  me  that  men  seldom  act 
for  themselves ;  but  take,  for  the  most  part,  a  tone  or  bias  from  some  individual 
master. 

By  education  most  have  been  misled ; 

So  they  believe,  because  they  were  so  bred. 

Gentlemen,  I  had  the  resolution  to  think  for  myself — ay,  and  to  act,  and 
my  conviction,  gained  from  much  and  extensive  experience,  is,  that  all  dis- 
eases may  not  only  be  successfully  treated  without  loss  of  blood ;  but  that 
blood-letting,  however  put  in  practice,  even  where  it  gives  a  temporary  relief, 
almost  invariably  injures  the  general  health  of  the  patient.  Englishmen ! 
you  have  traversed  seas,  and  dared  the  most  dangerous  climes  to  put  down 
the  traffic  in  blood  ;  are  you  sure,  that  in  your  own  homes  there  is  no  such 
traffic  carried  on — no  Guinea  Trade  ? 

In  connexion  with  blood-letting,  in  the  treatment  of  inflammation,  we 
generally  find 

Abstinence  or  Starvation 

recommended.  Beware  of  carrying  this  too  far !  for  "  abstinence  engenders 
maladies."  So  Shakspeare  said,  and  so  nature  will  tell  you,  in  the  teeth  of 
all  the  doctors  in  Europe  !  Abstinence,  Gentlemen,  may  produce  almost 
every  form  of  disease  which  has  entered  into  the  consideration  of  the  physi- 
cian ;  another  proof  of  the  unity  of  morbid  action,  whatever  be  its  cause. — 
You  remember  what  I  told  you  of  the  prisoners  of  the  penitentiary  ;  but  I 
may  as  well  re-state  the  facts  at  this  lecture.  In  the  words  of  Dr.  Latham, 
then,  "  An  ox's  head,  which  weighed  eight  pounds,  was  made  into  soup  for 
one  hundred  people  ;  which  allows  one  ounce  and  a  quarter  of  meat  to  each 
person.  After  they  had  been  living  on  this  food  for  some  time,  they  lost  their 
colour,  flesh,  and  strength,  and  could  not  do  as  much  work  as  formerly.  At 
length  this  simple  debility  of  constitution  was  succeeded  by  various  forms  of 
disease.  They  had  scurvy,  diarrhoea,  low  Fever,  and  lastly,  diseases  of 
the  brain  and  nervous  system. 

"The  affections,"  Dr.  Latham  continues,  "which  came  on  during  this 
faded,  wasted,  weakened  state  of  body,  were  headache,  vertigo,  delirium,  con- 
vulsions, apoplexy,  and  even  mania.  When  blood-letting  was  tried  [why 
was  it  tried  ?]  the  patients  fainted,  after  losing  five,  four,  or  even  lewer 
ounces  of  blood.  On  examination,  after  death,  there  was  found  increased 
vascularity  of  the  brain,  and  sometimes  fluid  between  its  membranes  and  its 
ventricles."  Is  not  this  a  proof  of  what  I  stated  to  you  in  my  last  lecture, 
that  the  tendency  to  hemorrhagic  development  does  not  so  much  depend  upoft 
fulness  of  blood,  as  upon  iveaknrss  of  the  coals  of  the  containing  vessels? — 
starvation,  you  see,  actually  producing  this  disease — in  the  brain  at  least. 


LECTURE  IV.  95 

In  all  the  higher  animals,  man  included,  the  substances  composing  the  food 
are  converted  into  blood  in  precisely  the  same  manner.  Crushing  and  com- 
minuting it  with  their  teeth,  they  reduce  it  by  the  aid  of  their  saliva  to  a  pulp, 
and  by  the  action  of  their  tongue  and  other  muscles,  convey  it  in  that  state  to 
the  gullet ;  the  Epiglottis,  or  valve  of  the  windpipe,  shutting  simultaneously, 
so  as  to  prevent  all  intrusion  in  that  quarter — though  some  of  you,  when  at- 
tempting to  speak  and  eat  at  the  same  time,  may  have  had  the  misfortune  to 
let  a  particle  enter  the  "  wrong  throat ;"  I  need  say  nothing  of  the  misery  of 
that.  When  the  food  reaches  the  stomach,  into  which  it  is  pushed  by  the 
muscular  apparatus  of  the  gullet,  a  new  action  commences.  Pooh,  pooh  !  I 
hear  you  say,  all  this  we  know  already  ;  but,  Gentlemen,  what  you  know 
may  be  news  to  somebody,  and  as  I  see  strangers  listening  with  apparent  at- 
tention, I  will  proceed  as  I  have  begun.  Well,  then,  to  continue.  Once  in 
the  stomach,  the  food  becomes  mixed  with  the  gastric  juice,  a  fluid  peculiar 
to  that  organ  ;  and  this  fluid  works  so  great  an  alteration  upon  it,  that  it  is 
no  more  the  same  thing.  It  is  now  what  medical  men  term  "  Chyme" — but 
this  is  not  the  only  change  it  has  to  undergo  ;  for  scarcely  has  the  chyme  left 
that  great  receptacle  of  gluttony,  and  entered  the  small  intestines,  when  it 
receives  a  supply  of  another  fluid  from  a  gland  called  the  pancreas  ;  and  yet 
another  from  the  ducts  of  the  liver,  a  still  larger  gland  ;  and  this,  under  the 
mysterious  name  of  Bile,  some  of  you  may  possibly  have  heard  of  before  ! — 
By  this  last  fluid  it  is  turned  to  a  white  colour,  and  from  Chyme  its  name  is 
now  changed  to  "  Chyle."  Why,  upon  my  word,  I  do  not  know,  both  words 
signifying  precisely  the  same  thing — "juice  !"  But  as  nothing  in  nature 
will  go  on  constantly  the  same  without  change,  the  "  Chyle"  must  needs 
separate  into  two  parts  ;  one  nutritious,  the  other  the  reverse  ;  one  portion 
enters  into  the  formation  of  every  part  of  the  body,  the  other  is  excremen- 
titious,  and  must  be  expelled  from  it.  For  the  nutritious  portion  a  million  of 
mouths-are  ready.  These  belong  to  a  system  of  vessels,  called,  from  the 
milky  appearance  of  their  contents,  the  Lacteals,  and  they  pervade  the  entire 
alimentary  canal.  A  great  viaduct  termed  the  Thoracic  duct,  receives  them 
all,  and  this  again,  under  a  new  name  (the  receptaculum  Chyli),  passing  up- 
wards along  the  front  of  the  spinal  column,  drops  its  contents — namely,  the 
nutritious  portion  of  the  Chyle,  into  the  left  subclavian  veix,  a  large  blood- 
vessel leading  under  the  left  collar-bone  to  the  heart.  Here  the  chyle  is  no 
longer  chyle  ;  meeting  and  mixing  with  the  blood,  it  becomes  Blood  in  fact, 
to  be  sent  first  by  the  right  chamber  of  the  heart  through  the  lungs,  and  then 
by  the  left  chamber  circulated  to  all  parts  of  the  body.  In  that  now  living 
state,  it  successively  takes  the  shape  of  every  organ  and  atom  of  the  body ; 
again,  in  the  shape  of  the  excrementitious  secretions,  to  pass  in  due  time  to 
the  earth,  from  which  its  elements  were  first  derived. 

The  food  of  animals  supports  them  only  in  so  far  as  it  offers  elements  for 
assimilation  to  the  matters  of  the  various  organs  and  tissues  composing  their 
frames.  While  a  single  secretion  still  continues  to  be  given  off  from  the 
body  ",  while  the  kidneys  or  bowels,  for  example,  continue  to  perform  their 
office,  however  imperfectly,  it  must  be  manifest  to  you,  that,  without  some 
corresponding  dietetic  increment,  the  elemental  atoms  of  the  animal  organism 
must  sooner  or  later  be  so  far  expended,  as  to  leave  it  in  a  state  incompatible 
with  life.  How,  then,  let  me  ask,  can  you  reconcile  healthy  organisation 
with  starvation-practice  1  How  can  you  expect  to  find  even  the  appearance 
of  health,  after  having  practised  the  still  more  barbarous  and  unnatural  pro- 
ceeding of  withdrawing  by  blood-letting  a  certain  portion  of  the  sum  of  all  the 
organs  that  are  being  formed  ?  The  quantity  of  food  which  animals  take, 
diminishes  or  increases  in  the  same  proportion  as  it  contains  more  or  less  of 
the  substance  which  chemists  term  azote  or  nitrogen.  This,  as  you  well 
know,  is  most  abundant  in  animal  food,  but  all  vegetables  possess  more  or 
less  of  it.  Rice,  perhaps,  contains  less  than  any  other  grain,  and  that  is  the 
reason  why  the  Asiatics  can  devour  such  quantities  of  it  at  a  time,  as  they 


96  LECTURE  IV. 

are  in  the  habit  of  doing.  You  would  be  quite  surprised  to  see  the  natives 
of  India  at  meal-time.  Sitting  cross-legged  on  their  mats,  a  great  basin  of 
rice  before  them,  with  mouth  open  and  head  thrown  back,  they  cram  down 
handful  after  handful,  till  you  wonder  how  their  stomachs  can  possibly  con- 
tain the  quantity  they  maks  disappear  so  quickly. 

The  most  cursory  examination  of  the  human  teeth,  stripped  of  every  other 
consideration,  should  convince  any  body  with  the  least  pretension  to  brains, 
that  the  food  of  man  was  never  intended  to  be  restricted  to  vegetables  exclu- 
sively. True,  he  can  subsist  upon  bread  and  water,  for  a  time,  without  dy- 
ing, as  the  records  of  our  prisons  and  penitentiaries  can  testify  ;  but  that  he 
can  maintain  a  state  of  health  under  such  circumstances,  is  as  utterly  and 
physically  impossible  as  that  the  lion  and  the  panther  should  subsist  on  the 
restricted  vegetable  diet  of  the  elephant.  The  dental  organisation  of  man 
partakes  of  the  nature  of  the  teeth  of  both  gramnivorous  and  carnivorous 
animals  ;  his  food  should,  therefore,  be  a  mixture  of  the  elements  of  the  food 
of  both  ;  and  with  this  mixed  nourishment,  the  experience  of  centuries  tells 
us,  he  supports  life  longest.  How  wretched,  on  the  contrary,  is  the  person 
doomed,  however  briefly,  to  an  exclusive  diet !  Sir  Walter  Scott  thus  de- 
scribes the  effects  of  what  he  terms  "  asevere  vegetable  diet,"  upon  himself. 
"  I  was  affected,"  he  says,  "  while  under  its  influence,  with  a  nervousness 
which  I  never  felt  before  or  since — a  disposition  to  start  upon  slight  alarms  ; 
a  want  of  decision  in  feeling  and  acting,  which  has  not  usually  been  my  fail- 
ing ;  an  acute  sensibility  to  trifling  inconveniences,  and  an  unnecessary  ap- 
prehension of  contingent  misfortunes  rise  to  my  memory  as  connected  with 
vegetable  diet."  How  can  a  dietetic  system  which  so  shakes  the  entire 
frame,  by  any  possibility  give  strength  and  stability  to  the  weaker  parts  of 
the  body — those  parts  whose  atomic  attractions  are  so  feeble,  that  every 
breath  that  blows  upon  the  whole  organism  shakes  them  to  pieces  ?  Must  it 
not,  in  the  very  nature  of  things,  make  the  man  predisposed  to  consumption 
more  certainly  consumptive — and  so  on,  throughout  the  whole  catalogue  of 
hereditary  disease  ? 

Observe  the  various  operations 

Of  food  and  drink  in  several  nations. 

Was  ever  Tartar  fierce  or  cruel 

Upon  the  strength  of  water  gruel? 

But  who  shall  stand  his  rasre  and  force, 

If  first  he  rides,  then  eats  his  horse? 

Salads,  and  eirgs,  and  lighter  fare, 

Tune  the  Italian's  gay  guitar ; 

And  if  I  take  Dan  Congreve  right, 

Pudding  and  beef  make  Britons  fight. — Prior. 

That  abstinence  is  proper,  in  the  commencement  of  most  acute  disorders, 
nobody  will  doubt.  The  fact  is  proved  by  the  inability  of  the  patient  to 
take  his  accustomed  meal ;  his  stomach  then  is  as  unfit  to  digest  or  assimiliate 
nutriment,  as  his  limbs  are  inadequate  to  locomotion.  Both  equally  require 
rest.  But  to  starve  a  patient  who  is  able  and  willing  to  eat,  is  downright 
madness.  No  animal  in  existence  can  preserve  its  health,  if  fed  on  one  kind 
of  food  exclusively.  The  dog,  when  restricted  to  sugar  alone,  seldom  sur- 
vives the  sixth  week ;  and  the  horse,  if  kept  entirely  upon  potatoes,  would 
waste  away  day  by  day,  though  you  were  to  give  him  as  much  of  that  par- 
ticular diet  as  he  could  devour;  he  would  die  of  a  slow  starvation.  How 
many  persons,  even  in  the  upper  walks  of  life,  are  every  day  starved  to  dcatli  ! 
The  doctor  has  only  with  a  mysterious  shrug  to  whisper  the  word  "inflam- 
mation,"  and  it  is  quite  astonishing  to  what  miserable  fare  people  of  nil  O0H- 
ditiona  will  submit.  Instead  of  an  exclusive  vegetable  diet  being  a  cure  for 
all  complaints,  as  your  medical  wiseacres  assure  you,  I  know  no  complaint, 

except,  that  of  small-pox,  and  the  Other  COStagioua  disease.-;,  iliat  it  bus  DOt 
of  itself  produced.     The  only  thing  it  is  good  for,  in  my  \icw  of  the  matter. 


LECTURE  IV.  97 

is  to  keep  the  patient  to  his  chamber,  and  the  doctor's  carriage  at  the  door. 
You  see  what  a.  profitable  practice  it  must  be  for  the  apothecary — and  I'll  bet 
you  my  life,  the  physician  who  first  brought  it  into  fashion  made  his  fortune 
by  it.  Not  a  nurse  or  nostrum-vender  in  the  kingdom,  but  would  be  sure  to 
cry  him  up  to  the  skies  !  Not  an  apothecary  from  Gretna  Green  to  Land's- 
End,  but  could  tell  you  of  some  miracle  worked  by  him  ;  and  the  world, 
hearing  the  same  thing  eternally  rung  in  its  ears,  how  could  it  possibly  doubt 
the  greatness  of  "  Diana  of  the  Ephesians !" 

I  am  every  day  asked  by  my  patients  what  diet  they  should  take.  I  gene- 
rally answer  by  the  question,  "  How  old  are  you  ?"  Suppose  they  say. 
Forty — "  Forty  !"  I  rejoin  :  "  you  who  have  had  forty  years'  experience  of 
what  agrees  and  disagrees  with  you — how  can  you  ask  me,  who  have  no 
experience  of  the  kind  in  your  case  whatever?"  Surely,  Gentlemen,  a  pa- 
tient's experience  of  what  agrees  and  disagrees  with  his  own  particular  con- 
stitution, is  far  better  than  any  theory  of  yours  or  mine.  Why,  bless  my 
life  !  in  many  chronic  diseases  the  diet  which  a  man  can  take  to-day  would 
be  rejected  with  disgust  to-morrow  ;  under  such  circumstances,  would  you 
still,  according  to  common  medical  practice,  tell  a  sick  person  to  go  on  taking 
what  he  himself  found  worried  him  to  death  ?  Gentlemen,  I  hope  better 
things  of: you. 

The  only  general  caution  you  need  give  your  patients  on  the  subject  of  diet, 
is  moderation  ;  moderation  in  using  the  things  which  they  find  agree  with  them- 
selves best.  You  may  direct  them  to  take  their  food  in  small  quantities  at  a 
time,  at  short  periodic  intervals,  intervals  of  two  or  three  hours,  for  exam- 
ple ;  and  tell  them  to  take  the  trouble  to  masticate  it  properly  before  they 
swallow  it,  so  as  not  to  give  a  weak  stomach  the  double  work  of  mastication 
and  digestion, — these  processes  being,  even  in  health,  essentially  distinct. 
Unless  properly  comminuted  and  mixed  with  the  saliva,  how  can  you  expect 
the  food  to  be  anything  but  a  source  of  inconvenience  to  persons  whom  the 
smallest  trifle  will  frequently  discompose  ?  I  remember  an  anecdote  of  the 
late  Mr.  Abernethy  which  is  so  apropos  to  what  I  have  just  been  telling  you, 
that  I  do  not  know  I  can  better  finish  what  I  have  to  say  upon  the  subject 
of  the  diet  than  by  letting  you  hear  it,  even  at  the  risk  of  its  proving  to  some 
of  you  a  twice-told  tale  :  An  American  captain,  on  being  one  morning  shown 
into  his  consulting-room,  immediately,  in  Yankee  fashion,  emptied  the  con- 
tents of  his  mouth  upon  the  floor.  The  man  of  medicine  stared,  keeping  his 
hands  in  his  pockets,  according  to  his  custom,  until  the  patient  should  explain. 
•«  What  shall  I  do  for  my  dyspepsy  ?"  asked  the  American  captain.  "  Pay 
me  your  fee,  and  I'll  tell  you,"  replied  the  doctor.  The  money  was  pro- 
duced, and  this  advice  given  :  "  Instead  of  squirting  your  saliva  over  my 
carpet,  keep  it  to  masticate  your  food  with."  Now,  upon  my  word,  he  could 
not  have  given  him  better  advice. 

Gentlemen,  I  shall  conclude  this  lecture  by  reading  to  you  a  few  of  many 
communications  I  have  received  from  medical  men  of  repute,  since  I  first 
published  my  doctrines  in  1836.  Dr.  Fosbroke,  of  Ross,  began  his  medical 
career  as  the  associate  of  the  immortal  Jenner ;  he  lived  in  his  house,  and 
materially  assisted  to  propagate  his  great  doctrine  of  Vaccination.  You  will, 
therefore,  fully  appreciate  the  evidence  of  a  gentleman  so  distinguished  in 
the  history  of  medicine.  From  a  letter  I  received  from  him  in  January, 
1840,  I  shall  read  to  you  a  passage  or  two  : — 

"  In  April,  1835,  our  acquaintance  and  free  communication  commenced ; 
and  though  I  pricked  up  my  ears,  like  one  thunderstruck,  at  your  wholesale 
denunciation  of  Blood-letting,  and  your  repeated  asseverations,  that  in  a  prac- 
tice embracing  to  my  knowledge  the  treatment  of  several  thousands  of  pa- 
tients per  annum,  you  never  employed  a  lancet  or  a  leech, — your  assertions 
made  an  impression,  though  it  was  slowly  and  reluctantly  received."  That 
it  strengthened  by  time,  Gentlemen,  you  will  see  by  the  next  extract.  "  No- 
thing can  be  more  striking  than  the  great  disparity  between  the  proportion 


9b  LECTURE  IV. 

of  persons  who  were  bled  in  the  first  two  years  of  my  Ross  practice,  1834 
and  1835,  (in  which  latter  year  I  first  became  acquainted  with  your  views,) 
and  the  three  following  yearn,  1836, 1837,  and  1838.  In  the  former  two  years, 
I  bled  one  in  seven ;  m  the  fourth,  only  one  in  twenty-eight ;  and  in  the  fifth 
year  I  bled  none  !  The  year  1839  is  now  concluded,  and  again  in  all  that 
time  I  have  not  bled  a  single  individual !" 

"  Your  crime  is,  that  you  are  before  the  age  in  which  you  live.  If  you 
had  done  nothing  else  but  put  a  bridle  upon  Blood-letting,  you  would  deserve 
the  eternal  gratitude  of  your  race,  instead  of  the  calumny  and  oppression  of 
the  two-legged  fools— the  Yahoos,  who  persecute  their  greatest  benefactors. 
But  how  can  you  expect  to  be  more  fortunate  than  your  predecessors  in  this 
respect?  The  health  of  Sir  Humphrey  Davy  was  affected  by  the  ingrati- 
tude of  his  country.  »  A  mind,'  said  he,  '  of  much  sensibility  might  be  dis- 
gusted, and  one  might  be  induced  to  say, — Why  should  I  labour  for  public 
objects  only  to  meet  abuse  ?  I  am  irritated  more  than  I  ought  to  be,  but  I 
am  getting  wiser  every  day, — recollecting  Galileo  and  the  times  when  philo- 
sophers and  public  benefactors  were  burnt  for  their  services.'  Whence  is 
all  this  ?  Pride,  poverty,  disappointment,  difficulty,  and  envy— and  '  envy,' 
said  Jenner  to  me  in  his  last  days,  '  is  the  curse  of  this  country.'  These  are 
kept  up  by  the  canker  of  party  and  the  taint  of  corruption. 

"  One  of  the  greatest  obstacles  to  reform  of  blood-letting  and  blistering, 
will  be  the  prospective  loss  of  guineas,  half-guineas,  five  shillings,  and  half- 
crowns.  I  saw  a  farmer  last  summer  come  into  a  druggist's  shop.  Some 
one  had  told  him  '  he  must  be  cupped  ;'  so  he  drove  a  bargain,  and  stepped 
into  a  back  room.  '  That  fool,'  said  I,  '  does  not  want  cupping.'  '  He  does 
not  look  as  if  he  did,'  said  the  druggist,  '  but  wc  can't  afford  to  let  him  go 
without.'  " 

Gentlemen,  the  next  two  communications  are  from  an  army  medical  officer, 
Staff-Surgeon  Hume,  a  gentleman  who,  from  the  nature  of  his  duties,  has 
the  very  best  opportunity  of  testing  any  particular  practice — and  one  who, 
were  he  to  give  a  false  report,  must  be  at  once  contradicted  by  regimental 
records.  His  statements  may  therefore  be  relied  upon  with  somewhat  greater 
confidence  than  the  Reports  which  annually  emanate  from  the  Medical  Officers 
of  Civil  Hospitals  and  Dispensaries  throughout  England.  From  the  Tables 
of  Mr.  Farre,  we  learn  that  these  officers  make  the  deaths  at  their  Institu- 
tions infinitely  less  than  the  average  number  of  deaths  of  sick  and  wal 
throughout  the  country !  so  that,  if  their  reports  be  correct,  sickness  would 
appear  to  be  actually  a  protection  against  death  !  Dr.  Hume  first  writes 
from  Dover,  6th  of  December,  1838  :  "  My  object  in  writing  is  to  congratu- 
late you  on  the  moral  courage  you  have  evinced  in  your  last  two  works.  I 
have  been  now  nearly  thirteen  years  in  the  service — mostly  in  charge  of 
an  hospital,  and  it  will  be  gratifying  to  you  to  know  that  an  old  fellow-stu- 
dent adopts  and  carries  out  your  principles  in  his  daily  practice.  I  have  not 
used  the  lancet  these  last  two  tears.  My  cases  yield  readily  to  warm 
baths,  cold  affusions,  emetics,  and  Quinine.  You  may  ask  me  where  I  have 
been  7  Four  years  in  Jamaica,  the  rest  in  North  America  and  home  Ben  ice. 
If  you  had  seen  Marshall's  digest  of  the  Annual  Reports  of  the  Army  Medi- 
cal Officers  since  1817,  you  might  have  quoted  it  as  a  proof  of  your  startling 
fact— the  Unity  of  Disease.  The  more  I  read  your  book,  the  more  1  am 
convinced  it  is  based  on  truth,  and  consistent  equally  with  common  sense  and 
nature's  laws.  However  little  this  age  may  appreciate  your  labours,  andthe 
persecution  you  are  likely  to  suffer  from  a  certain  class  of  doctors,  every  libe- 
ral mind  must  do  justice  to  your  unwearied  zeal.  Your  holding  op  to  ridicule 
the  most  fatal  of  all  medical  errors— Bleeding  a  patient  into  a  temporary 
calm  and  incurable  weakness,  ought  to  stamp  you  as  the  benefactor  ol  man- 
kind." 

The  same  gentleman  again  writes  to  me  from  Naas  Barracks,  I 
December,  1H3U.     "It  is  now  twelve  months  since  I  wrote  to  you 


LECTURE  V.  09 

that  I  had  not  used  the  lancet  for  the  two  previous  years  ;  and  I  am  now 
more  convinced  than  ever  of  its  utter  inutility  in  the  treatment  of  disease. 
Every  day's  experience  confirms  me  in  the  truth  of  your  doctrines.  During 
the  last  tear,  I  have  neither  bled,  leeched,  nor  cupped  in  any  case — and 
I  have  not  had  a  single  death  of  man,  woman,  or  child.  The  depot  was 
never  more  healthy — and  I  attribute  this  principally  to  my  abstaining, 
during  the  last  three  tears,  from  every  kind  of  depletion  in  the  treatment 
of  disease.  I  am  satisfied  that  Pneumonia  and  Enteritis,  (inflammation  of 
the  lungs  and  bowels)  which  are  at  present  the  bugbears  of  the  faculty,  are 
indebted  for  their  chief  existence  to  the  remedies  used  for  ordinary  ailments 
— namely,  bleeding,  starvation,  and  unnecessary  purging.  I  never  saw  a 
case  of  either  (and  I  have  seen  many)  in  which  the  patient  had  not  been  the 
inmate  of  an  hospital  previously  ;  where  he  had  undergone  the  usual  anti- 
phlogistic regimen,  or  had  been  otherwise  debilitated — as  in  the  case  of  long 
residence  in  a  warm  climate.  I  am  not  surprised  at  the  opposition  you  meet 
with.  It  has  ever  been  the  lot  of  those  who  have  done  good  to  humanity,  to 
be  offered  up  as  sacrifices  at  the  altars  of  ignorance,  prejudice,  and  obstinacy. 
It  is  a  fact  related  by  Harvey,  he  could  not  get  a  physician  above  the  age  of 
forty  to  believe  in  the  Circulation  of  that  Blood,  whose  value  in  the  economy 
You  have  so  forcibly  proved.  Although  I  yield  to  you,  as  your  just  due,  the 
origin  of  the  improved  principle  of  treating  disease,  I  take  credit  to  myself 
for  being  one  of  the  first  to  carry  it  into  effect ;  and  I  am  doubtful  whether  a 
person  in  private  practice  could  ever  so  far  overcome  prejudice  as  to  use  the 
cold  bath  with  the  confidence  I  do  in  every  kind  of  fever.  Its  power, 
together  with  a  warm  one,  is  truly  wonderful  in  equalising  the  temperature 
of  the  bodv.  When  I  compare  the  success  of  my  treatment  during  the  last 
few  years/with  that  of  my  previous  experience,  I  feel  inclined  to  curse  the 
professor  who  first  taught  me  to  open  the  vein  with  a  lancet. 

Yours  most  truly,  T.  D.  Hume." 


LECTURE  V. 

MEDICAL     DOCTRINES,     OLD     AND     NEW GOUT RHEUMATISM CUTANEOUS 

DISEASE — SMALL-POX PLAGUE YELLOW-FEVER DYSENTERY DROPSY 

CHOLERA. 

Gentlemen, 

When  a  young  man  has  run  the  usual  course  of  study  at  a  university, 
he  thinks  he  has  learned  everything  worth  knowing.  But  herein  he  grie- 
vously mistakes  ;  for  if  we  may  trust  Lord  Bacon,  who  had  no  interest  in 
the  matter,  rather  than  the  professors  who  have,  we  shall  find  that  "  in  the  uni- 
versities all  things  are  found  opposite  to  the  advancement  of  the  sciences ; 
for  the  readings  and  exercises' are  here  so  managed,  that  it  cannot  easily  come 
into  any  one's  mind  to  think  of  things  out  of  the  common  road  ;  or  if  here 
and  there  one  should  venture  to  use  a  liberty  of  judging,  he  can  only  impose 
the  task  upon  himself  without  obtaining  assistance  from  his  fellows  ;  and  if 
he  could  dispense  with  this,  he  will  still  find  his  industry  and  resolution  a 
great  hindrance  to  his  fortune.  For  the  studies  of  men  in  such  places  are 
confined  and  pinned  down  to  the  writings  of  certain  authors ;  from  which,  if 
any  man  happens  to  differ,  he  is  presently  represented  as  a  disturber  and 
innovator." 

Gentlemen,  in  this  passage  you  at  once  see  the  reason  why  medicine  has 
progressed  so  little  from  the  time  of  Hippocrates  to  the  present.  Every  per- 
son who  has  in  any  way  improved  the  practice  of  physic  has  had  to  repent 
it.  Harvey  lost  his  business  by  discovering  the  circulation  of  the  blood; 
Lady  Mary  Montague  suffered  in  her  reputation  for  introducing  the  small- 


100  LECTURE  V. 

pox  inoculation  ;  and  Jenner  for  a  long  period  of  his  life  was  victimised  for 
the  still  greater  improvement  of  the  Vaccine.  His  moral  character  was  for 
years  at  the  mercy  of  the  most  venal  and  corrupt  members  of  the  profession. 
"  Such,"  in  the  words  of  Milton,  "  are  the  errors,  such  the  fruits  of  misspend- 
ing our  prime  youth  at  schools  and  universities,  as  we  do,  either  in  learning 
mere  words,  or  such  things  chiefly  as  were  better  unlearned."  So  far  as 
they  relate  to  medicine,  the  doctrines  of  the  schools  have  been  a  succes- 
sion of  the  grossest  absurdities.  Let  us  briefly  glance  at  a  few  of  the  most 
prominent. 

For  several  ages  the'  state  of  the  Blood  was  held  to  be  the  cause  of  all 
disease — no  matter  how  the  disorder  originated.  Had  you  a  shivering  fit 
from  exposure  to  cold  or  damp,  the  "  Blood"  required  to  be  instantly  purified, 
— a  fever  from  a  bruise  or  fall,  the  only  thought  was  how  to  sweeten  "the 
blood  ;"  nay,  were  you  poisoned  by  hemlock  or  henbane,  "  the  blood,"  or  its 
blackness,  was  the  cause  of  all  your  sufferings — and  the  chief  anxiety  was 
how  to  get  rid  of  it.  It  never  occurred  to  the  physicians  of  that  day  that  the 
blood  was  an  indispensable  part  of  the  economy,  or  that  "  black  blood"  was 
better  than  no  blood  at  all ;  so  on  they  bled  and  continued  to  bleed  while  a 
drop  would  flow  from  the  veins.  When  their  patients  died,  it  was  all  owing 
to  the  accursed  "black  blood"  that  still  remained  in  the  system!-  How  to 
get  the  whole  out,  was  the  great  subject  of  scholastic  disputation,  and  treatises 
innumerable  were  written  to  prove  that  it  might  be  done.  In  progress  of 
time,  another  doctrine  arose,  namely,  that  all  diseases  first  originated  in  the 
Solids,  and  many  were  the  partisans  that  took  it  up  ;  so  that,  for  several 
centuries,  the  fluidists  and  solidists  divided  the  schools,  and,  like  Guelph  and 
Ghibelline,  ranged  themselves  under  their  respective  leaders.  What  medical 
man  is  ignorant  of  the  wars  they  waged,  the  ink  they  shed,  and  the  eloquence 
they  wasted  upon  the  still  unsettled  point,  whether  the  solids  or  fluids  ought 
to  bear  the  blame  of  first  imparting  disease  to  the  constitution  ! 

But  to  turn  from  these  to  the  doctrines  of  more  modern  schools.  The  chief 
feature  in  the  professional  notions  of  the  day,  is  the  assumption,  that  all  dis- 
eases may  be  traced  to  the  "  inflammation"  or  other  theoretical  state  of  a 
givenportion  of  the  body — one  school  taking  one  organ — another,  another; 
but  why  should  I  say  Organ  ?  seeing  there  are  professors  who  exclusively 
patronise  a  given  Tissue,  and  others  a  given  Secretion  even  ;  which  One 
thing,  after  they  have  wrapped  it  round  in  mummery  and  mysticism,  they 
gravely  proceed  to  magnify  into  the  very  Daniel  O'Connell  of  every  corporeal 
disturbance  !  Exposure  to  cold  and  heat,  the  midnight  revel,  and  the  oft- 
repeated  debauch — any,  or  all  of  these  may  have  injured  your  constitution. 
This,  of  course,  you  already  know  and  feel ;  so  you  wish  to  have  the  sense 
of  your  physician  upon  it.  And  what  does  he  do  ?  Why,  he  takes  you  by 
the  hand,  counts,  or  affects  to  count,  your  pulse,  looks  at  your  tongue  per- 
haps, and  then,  with  a  seriousness  becoming  the  occasion,  he  tells  you,  your 
"  Stomach  is  wrong ;"  and  so  far,  so  true,  as  your  own  want  of  appetite  and 
sensation  of  nausea  abundantly  testify.  But  as  if  this  were  not  enough,  and 
more  than  enough,  he  must  proceed  to  tell  you  the  cause  of  your  disease  ; 
and  what  does  he  say  that  was  ?  Being  a  "  stomach  doctor,"  of  course  he 
says,  "the  stomach"  again.  "  The  stomach,"  he  tells  you,  is  the  cause  of 
all;  your  headache,  tremor,  and  blue  devils,  all  proceed  from  "  the  stomach  !" 
But  herein,  if  I  mistake  not,  the  doctor  falls  into  the  same  error  as  a  man  who, 
seeing  a  house  in  ruins,  should  point  to  one  of  the  broken  bricks,  and  saddle 
it  with  the  whole  amount  of  mischief;  when,  in  really,  it  was  only  one  of 
many  coincident  effects  produced  by  agency  from  without,  such  as  accident, 
time,  or  tempest. 

For  a  considerable  space,  the  stomach  held  undisputable  sway  in  the 
medical  schools — John  Hunter  having  contributed  much  to  bring  it  into 
fashion.  Ilis  pupil  Abernethy  afterwards  coupled  the  whole  alimentary 
canal  with  it,  under  the  name  of  the  "  digestive  organs ;"  and  for  a  time  no- 


LECTURE  V.  10i 

body  dared  to  dispute  his  dictum  that  derangement  of  the  digestive  organs 
must  be  the  cause  of  all  disease.  Some  other  partialist  would  have  it,  how- 
ever, that  the  "  Liver"  is  the  great  source  of  all  ailments;  and  a  verv  con- 
venient substitute  this  organ  became  ;  for  not  only  did  it  save  the  physician 
the  trouble  of  thinking,  but  the  patient,  by  constantly  directing  his  mind  to  it, 
very  soon  found  out  that  the  liver  was  the  only  organ  of  the  body  worth  a 
moment's  cogitation.  Oh  !  "  the  Liver"  has  put  a  great  many  fees  into  the 
pockets  of  the  faculty,  and  might  continue  to  do  so  still,  but  for  Laennec's 
invention,  the  stethoscope.  Adieu,  then,  to  the  liver,  and  adieu  to  the 
stomach  and  digestive  organs  !  for,  from  the  moment  people  heard  of  this  in- 
strument, the  "  Heart  and  Lungs"  eclipsed  them  all.  We  have  no  liver  and 
digestive  organs  in  these  days  ;  we  have  only  the  "  Heart  and  Lungs  ;"  and 
these,  as  the  world  wags,  are  always  in  such  a  state — in  such  a  deplorable 
condition  of  disease  and  danger,  Heaven  only  knows  for  what  end  they  were 
given  us,  unless  our  bodies  were 


■  intended 


For  nothing  else  but  to  be  mended ! 

— in  other  words,  were  expressly  created  for  the  benefit  of  our  next-door 
neighbour,  the  apothecary  !  Never  was  such  a  catalogue  of  disease  as  these 
organs  have  entailed  upon  us  ;  but  the  curious  thing  is,  that  nobody  knew  it 
until  Laennec  made  the  discovery  by  means  of  the  stethoscope.  Since  then, 
leech,  lancet,  cupping-glass,  and  purge  have  followed  each  other  with  unex- 
ampled rapidity  ;  but  whether  the  "  fits"  and  "  sudden  seizures,"  which  now- 
a-days  carry  off  so  much  mortality,  be  the  effect  of  these  very  safe  and  gentle 
remedies,  or  of  the  "  Heart-disease,"  under  which  the  doctors,  in  their  inno- 
cence, are  pleased  to  class  them,  I  leave  to  persons  of  common  sense  and  com- 
mon discrimination  to  decide.  One  thing  is  certain,  physicians  have  made  a 
great  stride  since  the  days  of  Moliere — for  whereas  in  his  time,  the  only  organ 
they  ever  thought  or  theorised  about  was  the  lungs ;  now,  thanks  to  the 
stethoscope,  they  have  got  the  heart,  with  its  valvular  and  vascular  apparatus, 
to  the  bargain.  So  much  for  Organs,  Gentlemen;  let  us  now  speak  of  Tis- 
sues. To  be  chronologically  correct,  we  must  first  take  the  "  Skin" — for 
of  skin,  and  nothing  but  skin,  our  bodies  at  one  time  would  appear  to  have 
been  entirely  constructed.  The  skin  was  the  medical  rage,  and  the  doctors 
were  very  certain  they  had  made  a  great  discovery,  when  they  turned  their 
attention  to  it.  Derangement  of  the  skin  explained  everything  in  existence, 
and  many  other  things  besides  ;  whatever  your  sufferings,  the  answer  was 
always  the  same,  "  The  Skin,  Sir,  the  Skin !"  The  Skin  solved  every  pos- 
sible difficulty  ;  and  if  patients  were  pleased,  why  undeceive  them  1  Sick 
men  do  not  reason,  you  must  therefore  treat  them  like  children  ;  and  he  who 
can  best  impose  upon  their  credulity,  is  sure  to  become  the  popular  physician. 
The  skin,  however,  had  a  pretty  long  run ;  but,  like  its  predecessors,  it  was 
destined  to  fall  in  its  turn — to  be  supplanted  by  another  tissue,  the  "  Mucous 
Membrane."  In  the  hands  of  Broussais,  the  "  Mucous  Membrane"  first  rose 
to  eminence.  Bustling,  active,  ready,  he  first  pushed  it  into  notice;  and  so 
skilled  was  he  in  all  the  arts  of  scholastic  juggling,  that  not  only  did  he  parry 
every  blow  aimed  against  his  favourite  theme  by  the  skin  supporters,  but  he 
at  last  obtained  for  it  so  great  an  influence  in  the  sick-room,  that  no  patient 
of  importance  could  be  legitimately  put  to  death  till  he  had  been  first  called 
in  to  prescribe  something  for  the  "  Mucous  Membrane."  Broussais  thus  be- 
came the  French  medical  dictator — and  the  "  Mucous  Membrane"  the  French 
ruling  doctrine.  Carried  by  his  numerous  partisans  and  disciples  into  every 
commune  in  France,  the  "  Mucous  Membrane"  at  last  found  its  way  into 
England,  where  it  was  taken  up  by  the  late  Dr.  Armstrong  ;  and  an  excel- 
lent stepping-stone  it  proved  to  him  in  practice.  Every  body  came  to  hear 
what  he  had  to  say  of  the  "  Mucous  Membrane."  You  could  not  have  an  ache 
in  your  back,  or  a  cramp  in  your  leg,  but  the  "  Mucous  Membrane"  was  at 
fault ;  nay,  had  you  a  pimple  on  your  nose,  or  a  pain  in  your  great  toe,  it 


102  LECTURE  V. 

was  still  the  "  Mucous  Membrane  !"  Nor  is  this  doctrine  even  now  quite 
exploded.  How  many  of  the  various  Secretio.ns  have  run  this  gauntlet 
of  accusation,  it  would  be  unprofitable  to  do  more  than  allude  to.  The 
Perspiration  was  at  onetime  much  in  vogue — and  "checked  perspiration" 
the  reply  to  every  inquiry.  Our  grandmothers  use  the  phrase  occasionally 
still ;  though  some  of  them  betray  a  leaning  to  the  system  of  the  Water- 
doctors — not  the  Water-doctors  of  the  present  day,  Priesnitz  and  his  followers, 
to  wit, — no,  quite  a  different  class  of  persons.  The  persons  I  speak  ol 
only  needed  to  inspect  your  water  to  find  out  a  cure  for  your  complaint. 
Many  curious  stories  come  to  my  mind  in  connexion  with  this  ;  but  the  sub- 
ject is  too  grave  to  be  trifled  with — let  us  therefore  pass  from  that  to  the 
"  Bile" — the  mysterious  cause  of  so  much  offending.  How  many  difficulties 
has  not  this  secretion  mastered  ?  How  many  has  it  not  made  where  none 
existed  before  ?  You  derange  every  organ  and  function  of  your  frame  by 
intemperance — "  the  Bile,"  not  the  Wine,  is  the  criminal !  You  have  head- 
ache from  Hard  Study,  it  is  still  "  the  Bile ;" — the  palpable  and  obvious 
agencies  going  for  nothing — while  one  of  many  effects,  produced  by  a 
common  cause,  is  absurdly  singled  out  as  the  father  and  mother  of  the 
whole ! 

I  have  still  to  notice  another  school  of  physicians,  who  ring  the  same 
changes  upon  a  word,  which,  having  no  very  definite  signification  itself,  may, 
therefore,  signify  anything  they  have  a  mind,  without  in  the  least  commit- 
ting them  in  the  opinion  of  the  public.  "  Rheumatism"  "  Gout,"  "  Scrofula," 
"  Scurvy," — what  is  the  meaning  of  these  terms  ?  They  are  synonymes 
simply,  having  alia  common  import,  fluidity  or  humour.  In  Rheumatism, 
we  have  merely  a  derivation  from  the  Greek  verb  feu  {Rfieo,  I  flow),  and 
Shakspeare  used  it  in  its  proper  sense,  when  he  said, 

Trust  not  these  cunning  waters  of  his  eyes, 
For  villany  is  not  without  such  Rheum. 

Then,  as  regards  Gout,  what  is  it  but  a  corruption  of  the  French  word 
goutte,  a  "  drop  ?"     And  this,  perhaps,  some  of  you  may  think  not  so  bad  a 
name  for  a  class  of  symptoms  which  occasionally  proceed  from  M  a  drop  too 
much" — but  that  is  not  what  the  doctors  mean  by  the  term.     Gout  with  them 
is  merely  a  fanciful   "  humour."     "  Scrofula"  in  Latin,   and   "  Scurvy"  in 
Saxon,  have  the  same  signification, — namely,  a  "  dry  humour."     Only  think 
of  dry-humidity,  Gentlemen,  and  the  confusion  of  tongues  during  the  building 
of  Babel,  will  readily  occur  to  you  as  a  type  of  the  language  in  which  even 
now  medicine  is  taught  in  most  of  our  schools  !     The  German  physicians  of 
the  present  day  tell  us  that  "  Scrofula"  has  taken  the  place  of  "  Scurvy"  in 
the  European  constitution.     But  this  is  only  one  of  the  many  modes  in  which 
professors  play  at  "  hide  and  seek"  with  words.      Diseases  which  the  Con- 
tinental doctors  formerly  termed  scurvy,  they  now  term  scrofula ;  Heaven 
only  knows  what  the  same  corporeal  variations  will  be  called  before  the 
world  comes  to  an  end  !     So  much,  Gentlemen,  for  the  "  Humoral  school" 
— a  school  that  impressed  upon  its  disciples  a  doctrine  of  purgation  scarcely 
less  fatal  that  the  sanguinary  practice  of  the  present  pathologists.     In  fact, 
theirs  is  the  identical  system  of  "  Morrison  the  hygeist,"  and  all  those  quacks, 
who,  by  their  determined  perseverance  in  purging  away  a  fancied  "  impurity 
of  the  blood,"  have  too  often  purged  away  the  flesh  and  the  lives  of  their 
credulous  victims.     Do  people  at  this  time  of  day  require  to  be  told  that  you 
may  purge  a  healthy  man  to  death  ! — that  by  any  class  of  purgatives,  whe- 
ther vegetable  or  mineral,  you  may  so  disturb  every  action  of  the  body — may 
so  ajter  every  corporeal  structure  and  secretion,  that  not  one  shall   ba  <>t 
natural  consistency  or  appearance  !     By  the  eternal  use,  or  rather  mbut 
any  purgative  you  please,  in  a  previously  healthy  body,  you  may  so  chl 
the  alvine  secretions,  that  they  shall  take  the  form  of  any  »«  impurity"  vou 
fancy  ;  and  for  this  impurity  of  your  own  ennhon  you  innv,  day  bv  dav,  and 
week  by  week,  purge  and  purge,  till  you  have  brought  your  "patient "to  the 


LECTURE  V.  103 

state  of  inanition  which  constitutes,  as  I  shall  in  the  course  of  this  lecture 
explain  to  you,  the  disease  termed  "  Ship-scurvy."  See,  then,  the  effect  of 
that  "  Humoral  doctrine  !"  But  even  this  kind  of  folly  appeared  too  simple 
to  some  teachers,  and  these  taxed  their  invention  to  make  nonsense  com- 
pound. Who  has  not  heard  of  "Rheumatic-Gout?"  and  who  will  be  so 
bold  as  to  deny  its  existence  ?  Yet,  what  is  it  but  a  self-evident  absurdity  ! 
Its  literal  meaning  is,  "fluid  fluidity."  You  might  as  well  call  an 'injury 
from  6re<  an  igneous  burn.  Gentlemen,  does  such  jargon  convey  to  your 
minds  the  most  distant  idea  of  the  true  motions  which  take  place  in  the  body 
in  the  course  of  any  one  disease?  How,  then,  can  you  wonder  at  men  of 
observation  laughing  at  the  whole  medical  profession  ?  It  is  only  afool  or  a 
physician  who  could  be  duped  for  a  moment  by  such  puerility  ;  and  Lord 
Stowel  was  right  when  he  hinted  a  man  might  be  both  at  forty.  "  When 
youth  made  me  sanguine,"  says  Horace  Walpole,  "  I  hoped  mankind  might 
be  set  right.  Now  that  I  am  very  old,  I  sit  down  with  this  lazy  maxim,  that 
unless  one  could  cure  men  of  being  fools,  it  is  to  no  purpose  to  cure  them  of 
any  folly,  as  it  is  only  making  room  for  some  other."  This,  I  believe,  was 
said  in  regard  to  religious  doctrines  ;  but  that  it  applies  equally  well  to  medical 
doctrines,  may  be  seen  from  a  statement  of  Sir  William  Temple  : — "  In  the 
course  of  my  life,"  he  says,  "  I  have  often  pleased  or  entertained  myself, 
with  observing  the  various  and  fantastical  changes  generally  complained  of, 
and  the  remedies  in  common  vogue,  which  were  like  birds  of  passage,  very 
much  seen  or  heard  of  at  one  season,  and  disappeared  at  another,  and  commonly 
succeeded  by  some  of  a  very  different  kind.  When  I  was  very  young,  nothing 
was  so  much  feared  or  talked  of  as  Rickets  among  children,  and  consumptions 
among  young  people  of  both  sexes.  After  these,  the  spleen  came  into  play,  and 
grew  a  formal  disease.  Then  the  scurvy,  which  was  the  general  complaint, 
and  both  were  thought  to  appear  in  many  various  guises.  After  these,  and 
for  a  time,  nothing  was  so  much  talked  of  as  the  ferment  of  the  blood,  which 
passed  for  the  cause  of  all  sorts  of  ailments,  that  neither  physicians  nor  pa- 
tients knew  well  what  to  make  of;  and  to  all  these  succeeded  vapours,  which 
served  the  same  turn,  and  furnished  occasion  of  complaint  among  persons 
whose  bodies  or  minds  ail  something,  but  they  know  not  what ;  and  among 
the  Chinese,  would  pass  for  mists  of  the  mind,  or  fumes  of  the  brain,  rather 
than  indisposition  of  any  other  parts.  Yet  these  employ  our  physicians  more 
than  any  other  diseases,  who  are  fain  to  humour  such  patients  in  their  fancies 
of  being  ill,  and  to  prescribe  some  remedies,  for  fear  of  losing  their  practice  to 
others  that  pretend  more  skill  in  finding  out  the  cause  of  diseases,  or  care  in 
advising  remedies,  which  neither  they  nor  their  patients  find  any  effect  of, 
besides  some  gains  to  one  and  amusement  to  the  other.  As  Diseases  have 
changed  vogue,  so  have  Remedies,  in  my  time  and  observation.  I  remem- 
ber at  one  time  the  taking  of  tobacco  ;  at  another,  the  drinking  of  warm  beer, 
proved  universal  remedies — then  swallowing  of  pebble-stones,  in  imitation 
of  falconers  curing  hawks.  One  doctor  pretended  to  help  all  heats  and  fevers 
by  drinking  as  much  spring-water  as  the  patient  could  bear;  (Priesnitz's  plan?) 
at  another  time  swallowing  up  a  spoonful  of  powder  of  sea-biscuit  after  meals, 
was  infallible  for  all  indigestion,  and  so  preventing  diseases.  Then  coffee 
and  tea  began  their  successive  reigns.  The  infusion  of  powder  of  steel  has 
had  its  turn  ;  and  certain  drops  of  several  names  and  compositions.  But 
none  that  I  find  have  established  their  authority,  either  long,  or  generally,  by 
any  constant  and  sensible  successes,  but  have  rather  passed  like  a  mode  which 
every  one  is  apt  to  follow,  and  finds  the  most  convenient  or  graceful  while  it 
lasts,  and  begins  to  dislike  in  both  these  respects  when  it  goes  out  of  fashion. 
Thus  men  are  apt  to  play  with  their  healths  and  their  lives,  as  they  do  with 
their  clothes ;  which  may  be  the  better  excused,  since  both  are  so  transitory, 
so  subject  to  be  spoiled  with  common  use,  to  be  torn  by  accidents,  and  at  last 
to  be  so  worn  out.  Yet  the  usual  practice  of  physic  among  us  runs  still  the 
same  course,  and  turns  in  a  manner  wholly  upon  evacuation,  either  by  blood- 


104  LECTURE  V. 

letting,  vomits,  or  some  sorts  of  purgation ;  though  it  be  not  often  aspreed 
among  physicians  in  what  rases  or  what  degrees  any  of  these  are  necessary, 
nor  among  other  men  whether  any  of  these  are  necessary  or  no.  Montaigne 
questions  whether  purging  ever  be  so,  and  from  many  ingenious  reasons. 
The  Chinese  never  let  Blood."     Sensible  people  those  Chinese  ! 

Gentlemen,  you  now  see  the  correctness  of  Dr.  Gregory's  remark,  that 
medical  doctrines  are  little  better  than  "  stark-staring  absurdities."  And 
God  forgive  me  for  saying  it,  but  their  authors,  for  the  most  part,  have  been 
very  nearly  allied  to  those  charlatans  and  impostors,  who 

wrap  nonsense  round 

In  pomp  and  darkness,  till  it  seems  profound; 

Plav  on  the  hopes,  the  terrors  of  mankind 

With  changeful  skill ;         #         *         #         » 

While  reason,  like  a  grave-faced  mummy,  6tands 

With  her  arms  swathed  in  hieroglyphic  bands. — Moore. 

As  for  the  schools,  at  this  very  moment,  the  whole  regime  of  medical 
teaching  is  a  system  of  humbug,  collusion,  and  trick — embracing  intrigue  and 
fraud  of  every  kind,  with  the  necessary  machinery  of  hebdomadal  Journals  and 
Quarterly  Reviews,  by  which  the  masters  are  enabled  to  keep  down  truth, 
and  mystify  and  delude  the  student  and  country  practitioner  at  their  pleasure. 
In  physic,  now  as  formerly,  the  very  clever  world 


Bows  the  knee  to  Baal, 


And,  hurling  lawful  Genius  from  his  throne, 
Erects  a  6hrine  and  idol  of  its  own — 
Some  leaden  Calf — 

who,  by  virtue  of  his  puppet-position,  maintains  a  reputation  and  a  rule  in 
matters  medical,  to  which  neither  his  merits  nor  his  learning  in  the  very  least 
entitle  him  ;  nevertheless  he  reigns  the  Esculapius  of  the  day,  and  it  is  only 
in  the  next  age  that 

the  vulgar  stare, 

When  the  swollen  bubble  bursts,  and  all  is  air ! 

But  Gentlemen,  what  do  the  faculty  of  our  own  time  mean  by  the  term 

Gout? 

What  do  they  mean  by  it  ?  You  may  ask  them  that,  indeed.  Accord- 
ing to  Crabbe,  who  studied  physic,  but  left  the  profession  in  earlv  life  to 
take  orders, 

Some  to  the  Gout  contract  all  human  pain, 

They  view  it  raging  in  the  frantic  brain, 

Find  it  in  fevers  all  their  efforts  mar, 

And  see  it  lurking  in  the  cold  catarrh. 

Gout,  then,  may  be  anything  you  please  ;  for  if  the  received  opinion  be 
right,  this  offspring  of  Nox  and  Erebus,  this  vox  et  preterea  nihil,  takes  shapes 
as  many  and  Protean  as  there  have  been  authors  to  treat  of  it.  This  much 
I  may  venture  to  assure  vou,  that  nothing  will  so  soon  help  a  man  to  a  chariot 
as  to  write  a  book  with  Gout  for  its  title — for  being  supposed  to  be  a  disease 
peculiar  to  aristocracy,  every  upstart  is  fain  to  affect  it.  You  cannot  phase 
a  mushroom  squire,  or  a  retired  shopkeeper  better  than  by  telling  him 
his  disease  is  "  Gout" — "  Gout  suppressed" — "  Gout  retrocedent" — "Gout 
in  this  place,"  or  "  Gout  in  that !"     And  what  is  Gout  ? 

Of  all  our  vanities  the  motlieat — 


The  merest  word  th.it  ever  tooled  tli<-  ear, 
From  out  tlio  schoolman's  jargon  I — Hvkox. 

In  sober  seriousness,  is  there  such  a  disorder  ns  (.'nut.  ?  Gentlemen,  ns  a 
"counter  to  reckon  hy,"  you  may  use  the  word  s  having  first  so  tar  made 
yourselves  acquainted  with  its  real  meaning  that  nobody  shall  persuade  vou 


LECTURE   V.  105 

that  it  is  in  itself  anything  but  a  piece  of  hypothetical  gibberish,  invented  by 
men  who  knew  as  little  of  disease  and  its  nature  as  the  tyros  they  pretended 
to  illuminate.  When  a  lady  or  gentleman  of  a  certain  age  complains  to  you 
of  a  painful  swelling  in  some  of  the  joints  of  the  hand  ox  foot,  you  may  say, 
if  you  please,  that  such  patient  has  got  the  gout.  If  the  same  kind  of  "swell- 
ing should  appear  in  the  knee  or  hip-joint,  or  take  the  shape  of  an  enlarged 
gland  or  a  rubicund  nose,  you  must  then  change  your  phrase  ;  and  you  may 
easily  exhaust  a  volume  in  pointing  out  the  difference  betwixt  them.  But 
as  neither  this  kind  of  disquisition,  nor  the  baptizing  your  patient's  disease  by 
one  name  or  another,  can  in  the  very  least  help  you  to  cure  it,  I  may  just  as 
well  explain  to  you  that  this  swelling,  like  every  other  malady  incident  to 
man,  is  not  only  a  development  of  constitutional  disease,  but  comes  on  in  fits 
or  paroxysms : — you  have  all  heard  of  a  "  fit  of  the  Gout."  Gentlemen,  you 
will  find  this  fit  in  one  case  perfectly  periodic  and  regular  in  its  recurrence  ; 
in  another,  less  determinate  as  to  the  time  of  its  approach.  The  result  of 
repeated  paroxysms,  as  in  other  diseases  where  great  heat  and  swelling 
take  place,  must  be  a  tendency  to  decomposition ;  in  this  instance,  the  pro- 
duct for  the  most  part  is  a  deposit  of  chalky  or  earthy  matter.  When  this 
happens,  nobody  will  dispute  the  name  you  have  given  to  the  disorder  ;  but 
should  the  result  of  the  decomposing  action  be  purulent  matter  or  ichor,  in- 
stead of  chalk  or  earth — which  neither  you  nor  any  body  else  can  know 
beforehand — you  must  not  be  astonished  if  a  rival  practitioner  be  called  in, 
to  give  the  disease  another  soubriquet ;  to  christen  it  anew  by  some  other  phonic 
combination  full  as  indefinite  as  the  first ;  and  which  may  thus  serve  you  both 
to  dispute  about  very  prettily  from  one  end  of  the  year  to  the  other,  without 
either  of  you  becoming  a  whit  the  wiser  !  You  see,  then,  that  the  only  dif- 
ference betwixt  what  is  called  "  gout,"  and  what  is  called  "  inflammation," 
is,  that  the  result  of  the  morbid  action  in  the  former  case,  is  earthy  instead  of 
purulent  deposit,  a  solid  instead  of  a  fluid  product.  Now,  this  difference 
may  be  accounted  for,  partly  by  hereditary  predisposition,  and  partly  by  the 
age  of  the  respective  subjects  of  each.  Young  plants  contain  more  sap  than 
old  ones  :  the  diseases  of  both  must  therefore  in  some  points  vary ;  for  though 
in  the  blood  of  the  old  or  middle-aged  we  find  the  same  elemental  principles 
as  that  of  infancy  and  youth,  from  these  elements  being  in  different  propor- 
tions, the  results  of  decomposition  must,  mutatis  mutandis,  be  different. — 
What  are  the  Causes  of  Gout?  One  writer  says  one  thing;  another,  an- 
other. Dr.  Holland,  Physician-Extraordinary  to  the  Queen,  is  among  the 
latest  who  has  written  upon  the  subject,  and  he  says  the  cause  is  "  a  morbid 
ingredient  in  the  blood  ;"  nay,  he  says,  "  it  cannot  be  denied."  Still,  not 
only  do  I  presume  to  dispute  his  dictum,  but  I  challenge  him  to  bring 
forward  a  tittle  of  proof  in  support  of  it.  His  whole  doctrine  of  gout,  I  ap- 
prehend, is  a  fallacy  ;  for  if  you  inquire,  the  patient  will  tell  you  that  he 
took  too  much  Wine  the  night  before  his  first  fit ;  or  that  he  got  Wet ;  or  had 
been  exposed  to  the  East  Wind  ;  or  had  been  Vexed  by  some  domestic  mat- 
ter. From  which  you  see,  the  causes  of  gout  are  anything  and  everything 
that  may  set  up  any  other  disease — Small-pox  and  the  other  Contagious 
Fevers  of  course  excepted.  A  paroxysm  of  gout  has  been  actually  brought 
on  by  loss  of  blood,  and  also  by  a  purge  ;  for  which  statement,  if  you  will 
not  believe  me,  you  may  take  the  authority  of  Parr  and  Darwin.  What, 
then,  is  the  remedy  ?  If  you  ask  me  for  a  specific,  I  must  again  remind  you 
there  is  no  such  thing  in  physic  ;  and  what  is  more,  the  man  who  understands 
his  profession  would  never  dream  of  seeking  a  specific  for  any  disorder  what- 
ever. No ;  the  remedies  for  gout  are  the  same  as  cure  other  diseases ;  namely, 
attention  to  temperature  during  the  fit,  and  the  exhibition  of  the  chrono- 
thermal  or  ague  medicines  during  the  remission ;  for  we  have  seen  that,  like 
the  ague,  it  is  a  periodic  disorder,  and  such  is  the  description  given  by  Syd- 
enham, who  was  half  his  life  a  martyr  to  it — to  say- nothing  of  Dr.  Samuel 
Johnson's  explanation  in  his  dictionary.     That  it  comes  on  like  the  ague  with 


10G  LECTURE  V. 

cold  shiverings,  the  experience  of  almost  every  case  will  tell  you  ;  but  as 
your  minds  may  be  too  much  occupied  with  school  theories  to  mark  that  fact 
for  vourselves,  I  will  give  it  to  you  in  black  and  white  in  tho  -words  of  Dar- 
win". Speaking  of  some  cases  o'f  the  disease,  he  says :  "  The  patients,  after 
a  few  davs,  were  both  of  them  affected  with  cold  fits  like  ague-fits,  anil  their 
feet  became  affected  with  gout."  To  meet  it  in  a  proper  manner,  you  must 
treat  the  disease  purely  as  an  ague.  With  quinine,  arsenic,  opium,  and 
colchicum,  I  have  cured  it  scores  of  times ;  and  truth  obliges  me  to  say,  I 
have  in  some  cases  failed  with  all.  Now  what  can  I  say  more  of  any  other 
disease  ?  Every  day  you  hear  people  talk  of  the  "  principle"  of  a  thing,  but 
really  without  knowing  what  they  are  talking  about.  The  true  meaning  of 
the  word  "  principle"  is  Unity— something  simple  or  single  to  which  you 
may  specially  refer  in  the  midst  of  an  apparently  conflicting  variety.  That 
a  perfect  unity  of  type  pervades  all  the  variations  of  disease  is  indisputable, 
and  of  the  correctness  of  a  unity  or  principle  to  guide  your  treatment,  there  it 
as  little  doubt.  What,  then,  are  all  your  school-divisions  but  "  flocci,  nauci, 
nihili,  pili !"  I  shall  now  give  you  a  case  or  two  which  may  perhaps  suffice 
to  show  you  my  treatment  of  gout. 

Case  1.— Colonel  D ,  aged  60,  had  a  fit  of  gout  which  came  on  every 

iright,  and  for  which  leeches  and  purgation  had  been  ineffectually  prescribed, 
before  I  was  called  in.  I  ordered  a  combination  of  quinine  and  colchicum, 
hut  as  this  did  not  stop  the  fit,  I  changed  it  for  arsenic,  after  taking  which, 
the  patient  had  no  return. 

Case  2.— Captain  M ,  aged  56,  had  a  fit  of  gout  which  recurred  every 

night  during  his  sleep.  I  prescribed  arsenic  without  effect ;  I  then  gave  him 
quinine,  which  acted  like  magic.  The  same  gentleman,  twelve  months  after, 
had  a  recurrence,  but  was  much  disappointed,  on  resuming  the  quinine,  to 
obtain  no  relief.  I  then  prescribed  arsenic,  which,  though  it  failed  the  year 
before,  this  time  perfectly  succeeded !  a  lesson  to  such  as  would  vaunt  any 
remedy  as  a  specific  for  any  disease. 

The  influence  of  the  passions  in  causing  or  curing  gout  is  well  known. — 
One  of  many  cases  so  cured  cornea  just  at  this  moment  to  my  mind.  A 
country  clergyman  was  laid  up  with  a  severe  attack  of  the  gout— his  wife 
having  heard  of  the  effect  of  surprise  in  cases  of  the  kind,  dressed  up  a  large 
hare  in  baby  clothes,  and  brought  it  to  his  bed-side,  telling  him  how  fear- 
fully changed  their  child  had  become.  The  old  gentleman  eyed  the  animal 
with  a  look  of  terror,  sprung  out  of  bed.  and  complained  of  his  foot  no  more  ! 
Now,  Gentlemen,  as  gout,  like  ague,  is  a  remittent  disease,  and  curable  m 
the  same  manner— whether  by  mental  or  physical  agency— what  right  have 
we  to  assume  that  its  cause  is  a  "  morbid  ingredient  in  the  blood,"  any  more 
than  that  the  cause  of  ague  is  ?  Still,  let  us  suppose  for  a  moment  that  it  is 
the  effect  of  a  "morbid  ingredient  in  the  blood  ;"  what,  then,  allow  me  to 
ask,  is  this  morbid  ingredient  doing  all  the  time  of  remission  ?  Does  it  sleep 
or  wake  during  this  interval  of  immunity  ?  and  how  comes  it  that  arsenic, 
quinine,  and  colchicum  so  often  neutralise  its  effects — while  purgation  and 
blood-letting,  in  too  many  instances,  produce  a  recurrence?  In  a  word,  is 
not  this  "  morbid  ingredient  in  the  blood"  a  mere  crotchet  of  Dr.  Holland's 
brain  ? — a  goblin — a  phantom — that,  like  other  goblins  and  phantoms,  disap- 
pears the  moment  the  daylight  comes  in  ! 

Having  stated  my  reasons  for  dissenting  from  Dr.  Holland's  hypothetic 
view  of  the  case  of  gout,  it  may  not  be  out  of  place  here  to  request  your  at- 
tention to  some  points  of  infinitely  greater  importance,  upon  which  that  phy- 
sician and  myself,  by  some  curious  fatality,  maintained  a  remarkaMe  coi.n- 
cidenck  of  opinion.  The  following  passages  occur  in  his  Medical  Notes  and 
Reflections. 

"Has  sufficient  weight  been  assigned  in  our  pathological  reasonings  to  that 
principle  which' associates  together  so  many  facts  in  the  history  of  dii 
namely,  the  tendency,  in  various  morbid  actions,   to  distinct  intkiimissio> 


LECTURE  V.  107 

of  longer  or  shorter  duration,  and  more  or  less  perfect  in  kind  ?"  "  The  sub- 
jection of  so  many  diseased  actions  to  this  common  law,  establishes  rela- 
tions which  could  not  have  been  learned  from  other  sources,  and  which  have 

MUCH  VALUE  EVEN  IN  THE   DETAILS  OF  PRACTICE!" 

Again,  he  says,  "  It  will  probably  be  one  of  the  most  certain  results  of 
future  research,  to  associate  together,  by  the  connexion  of  causes  of  common 
kind,  diseases  now  regarded  as  ivlwlly  distinct  in  their  nature,  and  arranged 
as  such  in  our  systems  of  nosology .  This  remark  applies  very  widely  through- 
out all  the  genera  of  disease."  "  We  can  scarcely  touch  upon  this  subject  of 
Fever  (particularly  that  which  our  present  knowledge  obliges  us  to  consider 
as  of  idiopathic  kind),  without  finding  in  it  a  bond  with  which  to  associate  to- 
gether numerous  forms  of  disease,  but  withal  a  knot  so  intricate,  that  no 
research  has  hitherto  succeeded  in  unravelling  it." 

Now,  what  does  Idiopathic  mean  ?  It  means  peculiar  or  primary — in  op- 
position to  symptomatic  disease,  or  diseases  of  long  standing.  The  pro- 
fession, then,  according  to  Dr.  Holland — and  he  is  quite  right — have  been  all 
perfectly  in  the  dark  in  regard  to  the  beginning  of  the  disease.  The  "  knot" 
they  have  for  so  many  centuries  been  trying  to  unravel,  I  hope  he,  they,  and 
every  body  else  will  now  consider  as  completely  untied  ;  but  not,  as  I  shall 
in  a  few  minutes  prove,  in  consequence  of  Dr.  Holland's  "  prediction." 

When  speaking  of  the  influenza  and  other  epidemics,  Dr.  Holland  says  : 
"  I  may  briefly  notice  the  singular  analogy  to  the  milder  forms  of  Typhus 
and  intermittent  fever  which  these  epidemics  have  occasionally  presented." 
Why  be  puts  typhus  before  intermittent  fever,  I  know  not; "but  this  I  do 
know,  that  except  where  badly  treated,  the  influenza  seldom  takes  the 
"typhoid"  shape.  However,  Dr.  Holland  admits  he  has  prescribed  bark  in 
influenza  with  very  great  advantage. 

On  the  subject  of  temperature,  the  same  physician  thus  speaks  : — "  The 
patient  may  almost  always  choose  a  temperature  for  himself,  and  inconve- 
nience in  most  cases,  positive  harm  in  many,  will  be  the  effect  of  opposing 
that  which  he  desires ;  his  feeling  here  is  rarely  that  of  theory,  though  too 
often  contradicted  by  what  is  merely  such.  It  represents  in  him  a  definite 
state  of  the  body,  in  which  the  alteration  of  temperature  desired  is  the  best 
adapted  for  relief,  and  the  test  of  its  fitness  usually  found  in  the  advantage 
resulting  from  the  change.  This  rule  may  be  taken  as  applicable  to  all 
fevers,  even  to  those  of  the  exanthemateous  kind."  By  such  terms,  medical 
men  understand  small-pox,  chieken-pox,  measles,  and,  scarlet  fever.  Some 
include  the  plague. 

Dr.  Holland  asks :  "  Is  not  depletion  by  blood-letting  still  too  general  and 
indiscriminate  in  affections  of  the  brain,  and  especially  in  the  different  forms 
of  paralysis  ?  I  believe  that  the  soundest  medical  experience  will  warrant 
this  opinion.  The  vague  conception,  that  all  these  disorders  depend  upon 
some  inflammation  or  pressure  -which  it  is  needful  to  remove,  too  much  per- 
vades and  directs  the  practice  in  them  ;  and  if  the  seizure  be  one  of  sudden 
kind,  this  method  of  treatment  is  often  pursued  with  an  urgent  and  dangerous 
activity."  *  *  *  "  Theory  might  suggest  that  in  some  of  these  various 
cases,  the  loss  of  blood  would  lead  to  mischief.  Experience  undoubtedly 
proves  it ;  and  there  is  cause  to  believe,  that  this  mischief,  though  abated  of 
late  years,  is  still  neither  infrequent,  nor  small  in  amount."  It  is  now  the 
fashion  of  fashionable  practitioners  to  say,  "Oh,  there  has  certainly  been  too 
much  bleeding,"  and  "  Oh,  we  don't  bleed  as  we  used  to  do  ;"  but  it  is  not 
so  convenient  for  them  to  tell  who  opened  their  eyes  to  their  errors. 

Now,  Gentlemen,  if  any  of  you  be  disposed  to  question  by  whose  influence 
this  abatement  of  mischief  was  principally  brought  about,  I  may  suggest  that, 
from  numerous  letters  I  have  received  ftom  medical  men,  long  before  Dr. 
Holland's  volume  first  appeared,  my  writings  must  at  least  have  in  something 
contributed  to  it.  Dr.  Holland's  work,  from  which  I  quote,  was  published  by 
Messrs.  Longman  and  Co.,  in  1839.     Mark  that  date,  and  mark  also,  if  you 


108  LECTURE  V. 

please,  that  it  was  in  the  year  1836.  thrke  tears  before,  that  the  same  pub 
lishers  brought  out  my  work  The  Fallacy  of  Physic  as  taught  in  the  School*, 
wherein  I  stated  : — 

1.  "  We  hope  to  prove,  even  to  demonstration,  that  Fever,  Remittent 
or  Intermittent,  comprehends  every  shape  and  shade  which  disorder  can 
assume." 

2.  "  That  many  cases  of  disorder  have  been  observed  to  partake  of  the 
nature  of  Remittent  Fever,  and  to  derive  benefit  from  the  modes  of  treatment 
adapted  to  that  periodic  distemper,  we  are  sufficiently  aware.  But  we  have 
yet  to  learn  that  any  author,  ancient  or  modern,  has  detected  that  type,  and 
adcocated  that  treatment  in  every  shade  and  variety  of  disease.'1 

3.  "  That  attention  to  Temperature  is  the  end  of  all  medicine." 

4.  "  That  Blood-letting  might  be  advantageously  dispensed  with  in  all 
diseases,  even  in  apoplexy." 

Gentlemen,  some  of  you  may  have  read  an  anecdote  of  Dennis  the  Critic. 
Having  invented  a  new  mode  of  producing  theatrical  thunder,  he  submitted 
his  discovery  to  the  managers ;  but  their  high  mightinesses  only  affected  to 
laugh  at  it.  Some  weeks  afterwards,  he  went  to  see  a  play,  in  which  there 
was  a  thunder-scene.  "  Now,"  thought  Dennis,  "  is  my  turn — now  I  can 
afford  to  laugh  at  their  thunder  as  much  as  they  laughed  at  mine  ;"  but  judge 
his  surprise,  when,  instead  of  the  farcical  squall  he  expected,  his  ears  were 
saluted  with  a  thunder  as  terrible  and  true  as  the  "hurly-burly"  of  his  own 
invention.  Perceiving,  in  an  instant,  the  trick  that  had  been  played  him,  he 
cried  aloud,  "  By  G —  !  that's  my  thunder  !"  This,  or  something  like  this — 
always  excepting  the  irreverent  adjuration — was  the  sentiment  that  escaped 
me  when  I  first  perused  the  passages  I  have  read  to  you  from  the  Medical 
Notes  and  Reflections.  "  These  are  my  doctrines,"  I  said  ;  "  ay — the  iden- 
tical doctrines  which  Dr.  James  Johnson,  physician-extraordinary  to  the 
King  deceased,  two  years  before,  stigmatised  as  a  PYREXY-mania,  or  Fever- 
madness.  How  will  he  receive  them  now — now  that  they  are  patronised 
at  "  second  hand"  by  an  F.R.S.  and  a  physician-extraordinary  to  the  Queen 
that  reigns?"  That  was  my  exclamation — and  how  did  he  receive  them, 
Gentlemen  ?  Why,  he  praised  Dr.  Holland  to  the  skies ;  said  he  was  this, 
and  said  he  was  that;  and  concluded  by  telling  us  that  "  it  is  impossible  to 
lay  down  his  book  without  an  acquiescence  in  the  decision  of  the  public,  which 
has  placed  him  in  the  first  rank  among  the  practical  physicians  of  the  capital ;" 
adding,  moreover,  that  "his  bearing  toward  his  brethren  is  fair  and  open,  and 
his  candid  mind,  instructed  by  liberal  reading  and  polished  by  society, 
is  willing  to  allow  their  meed  of  merit  to  all."  But  not  a  syllable  did  Dr. 
James  Johnson  say  in  condemnation  of  Dr.  Holland's  prophecy,  that  "Fever" 
would  one  day  be  found  to  be  "  the  bond  with  which  to  associate  together 
numerous  forms  of  disease ;"  nor  did  he  remind  him  that  when  that  pro- 
phecy was  actually  fulfilled  by  me  to  the  letter  years  before  he,  Dr. 
Holland,  took  the  trouble  to  make  it,  he,  Dr.  James  Johnson,  ridiculed  it  as  a 
Fever-MADNESS  !  Gentlemen,  if,  in  the  course  of  his  "  liberal  reading,"  the 
Author  of  the  Medical  Nutes  and  Reflections  never  saw  the  Fallacy  of  jPkysic 
as  taught  in  the  Schools — nor  the  review  of  it  by  his  patron  Dr.  Johnson  ! 
nor  Dr.  Forbe's  equally  honest  criticism  of  it ! — nor  the  controversy  in  the 
Lancet,  to  which  the  former  gave  rise  ! — nor  heard  in  "  society"  the  remarks 
made  by  the  laughter-loving  part  of  the  profession,  when  that  controversy 
was  concluded  ! — nor  met  with  the  Unity  of  Disease — nor  the  many 
reviews  that  were  written  upon  it !  ! — you  must  acknowledge  the  "  coinci- 
dence" to  be  curious— startling  !  !  !  And,  further,  you  must  admit  that  this 
"coincidence"  ailbrds  another  of  many  proofs  of  the  truth  of  a  discovery, 
which,  when  Dr.  Holland — with  the  candor,  I  am  willing,  in  common  with 
Dr.  Johnson,  to  allow  him — takes  into  account  dates,  facts,  and  other  similar 
trifles,  I  hope  he  will,  in  return,  permit  me  now,  henceforth,  and  for  evev, 
to  cull  MINE!     Mean  while,   I  have  much  pleasure  in  uvailing  myself  of 


LECTURE  V.  109 

the  testimony  of  a  physician  so  eminent,  in  favour  of  its  "  value,  even 

IN   THE  DETAILS  OF  PRACTICE." 

[Shortly  after  the  above  observations  made  their  appearance  in  print,  Dr. 
Holland  addressed  to  me  a  letter  m  "  explanation."  The  correspondence 
which  followed  I  am  not  quite  at  liberty  to  give,  as  the  doctor  expressed  a 
wish  that  his  communication  should  be  kept  "  private."  This  much  I  may, 
however,  state,  that  though  couched  in  very  polite,  very  diplomatic  language, 
the  "  explanation"  afforded  by  his  letters  did  not  appear  to  me  to  be  any  ex- 
planation at  all.  His  observations  might  apply  to  this,  that,  or  the  other,  or 
anything  else  !  But  seriously,  if  Dr.  Holland  intended  to  do  more  than  shuffle 
me  out  of  my  discoveries,  why  did  he  send  a  "  private"  answer  to  my  pub- 
lished charge— or  insinuation,  if  he  like  it  better  1  The  concluding  para- 
graph of  his  last  letter  is  so  adroitly  worded,  that,  with  or  without  his  leave, 
I  must  quote  it.  "  It  gives  me  pleasure  to  know  that  you  find  anything  of 
truth  or  useful  suggestion  [suggestion!]  in  what  J  have  published.  And 
I  shall  be  gratified  by  any  opportunity  which  may  hereafter  occur  of  talking 
with  you  on  these  subjects,  of  common  interest  to  us,  out  of  print,  [no  doubt !] 
Ever,  my  dear  Sir,  yours  faithfully,  H.  Holland."  "  New  truths  of  a 
higher  order,"  says  an  enlightened  physiologist,  "  and  of  which  the  connexion 
is  not  seen  with  common  and  hackneyed  doctrines,  are  scouted  by  all,  and 
especially  sneered  at,  denied,  and  abused  by  the  base  creatures  who  have  just 
sense  enough  to  see' there  really  is  something  in  them — who  have  just  am- 
bition enough  to  make  them  hate  one  who  appears  to  know  more  than  they 
do ;  and  who  have  just  cunning  or  skill  enough  to  bias  minds  yet  weaker 
than  their  own.  To  crown  suitably  such  procedure,  the  doctrines  at  first 
denied  are  subsequently  pilfered  with  all  the  little  art  of  which  such  minds 
are  capable." — Alexander  Walker  on  the  Nervous  Syste?n.] 

From  this  digression  I  now  turn  to 

Rheumatism. 

Like  Gout,  the  word  "  Rheumatism"  conveys  nothing  beyond  the  expression 
of  the  false  theory  which  first  gave  rise  to  it.  But  as  we  are  compelled,  by  long 
custom,  to  retain  this  among  other  equally  unmeaning  terms,  I  may  tell  you, 
that  the  profession  of  the  present  day  class  under  it  numerous  affections  of  the 
great  joints,  particularly  such  as  have  come  on  suddenly,  and  are  attended 
with  much  pain  and  swelling.  You  will  find  that  these,  in  every  case,  have 
been  ushered  in  by  fever  fits.  The  young  and  middle-aged  are  more  liable 
to  rheumatism  than  the  extreme  old.  Like  the  gout,  it  is  a  remittent  disorder, 
and  Dr.  Haygarth,  long  ago,  wrote  a  work  illustrative  of  the  value  of  bark  in 
its  treatment.  My  own  practice  is  to  premise  an  emetic  ;  this  I  follow  up 
with  a  combination  of  quinine  and  colchicum.  If  that  mode  of  treatment  fail, 
I  have  recourse  to  opium,  arsenic,  guiaic,  mercury,  silver,  turpentine,  copaiba, 
arnica  montana,  aconite,  or  sulphur  —  or  combinations  of  them  —  all  of 
which  remedies  have  succeeded  and  failed  in  ague  as  well  as  in  rheumatism. 
In  most  instance  of  acute  rheumatism,  the  first  combination  will  be  found  to 
answer  perfectly  ;  though  in  cases  of  long  standing,  you  may  have  to  run 
from  one"  medicine  and  combination  of  medicine  to  another,  before  being  able 
to  bring  about  this  desirable  termination  ;  and  it  is  my  duty  to  confess  to  you, 
that  in  some  cases,  particularly  where  either  much  depletion,  or  much  mer- 
cury, or  both,  have  been  employed — as  I  grieve  to  say,  they  too  often 
are  in  the  primary  treatment — you  may  fail  with  every  means  you  may 
devise. 

Under  the  head  of  rheumatism,  medical  men  also  include  certain  muscular 
pains,  which  occur  in  various  parts  of  the  body,  but  which  are  unattended  by 
any  apparent  morbid  structural  development.  With  nitrate  of  silver  and 
prussic  acid,  I  have  often  cured  these  pains ;  and  with  the  cold  plunge-bath, 
I  have  sometimes  succeeded  after  every  other  means  had  failed.  Of  my  mode 
of  treating  acute  rheumatism,  I  will  give  you  two  examples. 


110  LECTURE  V. 

Case  1. — A  young  man,  aged  25,  had  been  suffering  severely  from  rheu- 
matism for  four  or  five  clays  before  I  saw  him.  At  this  time,  the  joints  of  his 
wrists  and  ankles  were  "much  swelled  and  exquisitely  painful ;  his  heart 
laboured,  and  was  in  such  pain  as  to  impede  his  breathing;  his  tongue  was 
foul  and  furred,  and  he  had  been  occasionally  delirious,  f  offered  an  emetic, 
which  was  some  time  in  operating,  but  when  it  did,  the  relief  was  signal.  I 
followed  this  up  with  pills  containing  a  combination  of  quinine,  blue  pill,  and 
colchicum,  and  in  two  days  he  was  sitting  up  with  scarcely  any  swelling 
remaining  in  the  affected  joints  ;  in  two  days  more  he  had  no  complaint. — 
Not  a  drop  of  blood  was  taken  in  this  case. 

Case  2. — A  gentleman,  aged  30,  after  exposure  to  wet  and  cold,  had  a 
shivering  fit  with  fever,  in  the  course  of  which  almost  every  joint  in  his  body 
became  swollen  and  very  painful.  He  was  bled,  leeched,  blistered,  and  took 
mercury  to  no  purpose,  before  I  was  called  in.  I  ordered  him  a  combination 
of  quinine,  colchicum,  and  opium,  which  agreed  so  well  with  him,  that  in 
three  days  I  found  him  free  from  every  symp^pm  but  weakness,  which  I 
presume  was  as  much  the  effect  of  the  former  sanguinary  treatment,  as  of 
the  disease  ;  at  any  rate,  he  had  certainly  suffered  very  severely.  But, 
Gentlemen,  like  every  other  disease  incident  to  man,  rheumatism  may  not 
only  be  cured  without  loss  of  blood,  but  without  any  physic  at  all ;  and  in 
evidence  of  this,  I  will  read  to  you  an  extract  from  the  writings  of  Syden- 
ham :  "  As  to  the  cure  of  rheumatism,"  he  says,  "  I  have  often  been  troubled, 
as  well  as  you,  that  it  could  not  be  performed  without  the  loss  of  a  great 
deal  of  blood ;  upon  which  account  the  patient  is  not  only  much  weakened 
for  a  time,  but  if  he  be  of  a  weakly  constitution,  he  is  most  commonly  rend- 
ered more  obnoxious  to  other  diseases  for  some  years,  when,  afterwards,  the 
matter  that  causes  the  rheumatism  (Sydenham,  like  Hippocrates,  was  a  dis- 
ciple of  the  Humoral  School)  falls  upon  the  lungs,  the  latent  indisposition  in 
the  blood  being  put  into  motion  by  taking  cold,  or  upon  some  slight  occasion. 
For  these  reasons,  I  endeavour  to  try  for  some  other  method  different  from 
bleeding,  so  often  repeated,  to  cure  this  disease ;  therefore,  well  considering 
that  this  disease  proceeded  from  an  inflammation,  which  is  manifest  from 
other  phenomena,  but  especially  from  the  colour  of  the  blood,  which  was 
exactly  like  that  of  Plcuritis,  I  thought  it  was  probable  that  this  disease 
might  be  as  well  cured  by  ordering  a  simple,  cooling,  and  moderately  nour- 
ishing diet,  as  by  bleeding  repeated,  and  those  inconveniences  might  be 
avoided,  which  accompanied  the  other  method  ;  and  I  found  that  a  whey- 
diet,  used  instead  of  bleeding,  did  the  business.  After  last  summer,  my 
neighbour  Matthews,  the  apothecary,  an  honest  and  ingenious  man,  sent  for 
me  ;  he  was  miserably  afflicted  with  rheumatism,  accompanied  with  the  fol- 
lowing symptoms.  He  was  first  lame  in  the  hip  for  two  days  ;  afterwards 
he  had  a  dull  pain  upon  his  lungs,  and  a  difficulty  of  breathing,  which  also 
went  off  in  two  days'  time  (both  remittent),  after  which  his  head  began  to 
pain  him  violently,  and  presently  the  hip  of  the  right  side  whirh  was  first 
seized  ;  and  afterwards,  according  to  the  usual  course  of  the  disease,  almost 
all  the  joints,  both  of  the  arms  and  legs,  were  afflicted  by  turns.  He  being 
of  a  weak  and  dry  habit  of  body,  I  was  afraid  that  by  taking  away  much 
blood,  his  strength,  before  but  infirm,  would  be  wholly  vanquished  ;  especially 
the  summer  being  so  far  spent,  it  was  to  be  feared  winter  would  come  before 
he  could  recover  his  strength,  weakened  by  frequent  bleeding,  and  therefore 
I  ordered  that  he  should  feed  on  nothing  but  whey  for  four  days.  Afterwards, 
I  allowed  him,  besides  the  whey,  white  bread  instead  of  a  dinner,  namely, 
once  a-day,  till  he  was  quite  well.  He,  being  contented  with  this  thin  diet, 
continued  the  use  of  it  for  eighteen  days  ;  only  I  at  last  indulged  him  in  1  read 
at  supper  too  ;  he  daily  drank  eighteen  pints  of  whey,  made  at  home,  where- 
with he  was  sufficiently  nourished.  After  these  days,  when  the  symptoms 
did  no  more  vex  him,  ami  when  he  walked  abroad,  I  permitted  him  to  eat 
flesh,  namely,  of  boiled   chickens,  and  other  things  of  easy  digestion  :  but 


LECTURE  V.  Ill 

every  fourth  day  he  was  dieted  with  whey,  till  at  length  he  was  quite  well, 
the  inconveniences  mentioned  above  being  quite  remedied  by  this  method, 
with  which  he  was  grievously  afflicted  ten  years  before,  bleeding  being  then 
used  by  my  order  for  his  cure,  and  often  repeated.  If  any  one  shall  condemn 
this  method,  because  it  is  plain  and  inartificial,  I  would  have  such  a  one 
know,  that  only  weak  people  despise  things  for  their  being  simple  and  plain ; 
and  that  I  am  ready  to  serve  the  public,  though  I  lose  my  reputation 
by  it.  And  I  will  say  that  I  do  not  at  all  question,  were  it  not  for  common 
prejudice,  that  the  said  method  might  be  accommodated  to  other  diseases,  the 
names  whereof  I  conceal  at  present,  and  that  it  would  be  more  beneficial  to 
the  sick  than  the  common  pomp  of  remedies  that  are  used  for  people 
when  they  are  just  dying,  as  if  they  were  to  be  sacrificed  like  beasts." — But 

The  Stone  ! — 

You  will  doubtless,  Gentlemen,  ask  me  whether  or  not  I  look  upon  that  also 
as  an  effect  of  intermittent  fever  ?  To  this  question  I  have  only  to  say,  that 
Stone  must  be  admitted  to  be  a  result  of  viorbid  urinary  secretion.  Can  any 
secretion  become  morbid  without  the  previous  occurrence  of  constitutional 
(in  other  words,  intermittent  febrile)  change  ?  Certainly  not;  then,  without 
such  change,  how  could  stone  become  developed  at  all  ?  moreover,  are  there 
not  times  of  the  day,  when  the  subject  of  it  is  better  and  worse,  and  this  not 
altogether  to  be  referred  to  the  period  of  micturition  ?  A  "fit  of  the  stone"  is 
as  common  an  expression  as  a  fit  of  the  ague.  Drs.  Prout  and  Roget,  who 
have  paid  much  attention  to  calculary  diseases,  state,  that  while  medicines 
styled  "  lithontriptics"  exert  but  little  influence  in  such  cases,  tonics  have 
almost  universally  ameliorated  the  condition  of  the  patient ;  and  what  are 
the  medicines  usually  termed  "  tonics,"  but  the  remedies  for  ague  ? 

Whether  gout  and  rheumatism  be  remittent  diseases  or  not,  or  whether 
they  be  remarkable  for  the  changes  of  temperature  and  action,  termed  Fever, 
nobody  but  such  as  prefer  books  of  nosology  to  the  book  of  nature  and  com- 
mon sense,  would  be  so  ignorant  as  to  question.  Whether  they  be  varieties 
of  the  same  disease,  is  another  thing ;  but  this  I  know,  they  are  both  first- 
cousins  to  ague,  and  by  treating  them  as  such,  the  practitioner  may  save 
himself  a  world  of  trouble,  and  the  patient  a  world  of  pain,  which  neither 
might  escape,  in  adopting  the  doctrine  of  the  "  pathologists,"  that  these  are  in- 
flammatory diseases,  and  only  to  be  subdued  by  leech,  lancet,  and  mercury 
to  salivation.  Gentlemen,  laugh  at  the  pathologists,  and  laugh,  too,  at  their 
disputations,  which,  being  all  about  nonsense,  can  never  possibly  come  to  a 
satisfactory  conclusion. 

The  calculary  (gritty)  or  stony  concretions  which  are  occasionally  de- 
posited in  the  different  joints  during  gout,  suggested  to  medical  men, 
even  at  an  early  period,  the  analogy  subsisting  betwixt  that  disease  and 
stone.  During  constitutional  disorders,  calculus  may  be  developed  in  any 
tissue  or  structure  of  the  body.  Salivary  concretions  are  common :  Pulmonary 
calculi  I  have  seen  in  two  instances  :  in  one  case  they  were  expectorated  by 
a  consumptive  female,  who  died  ;  in  the  other,  by  a  gentleman  whose  lungs 
being  otherwise  organically  uninjured,  recovered  his  health  completely  by 
attending  to  the  temperature  of  his  chest,  and  by  the  occasional  use  of  hydro- 
cyanic acid  and  quinine,  which  I  prescribed  for  him.  This  patient  had  pre- 
viously consulted  two  of  the  best-employed  medical  men  in  London,  one  a 
physician,  the  other  a  surgeon,  neither  of  whom  held  out  a  hope  for  him  but 
in  a  warm  climate.  Dr.  Chambers  and  Sir  B.  Brodie,  for  these  were  the 
practitioners  the  patient  previously  consulted,  showed  in  this  instance,  at  least, 
their  good  opinion  of  attention  to  temperature.  How  often  the  liver,  gall- 
bladder, and  kidney  are  the  seat  of  stone,  I  need  not  tell  you.  Taking  place 
in  the  course  of  an  artery,  calculus  is  erroneously  termed  "  ossification."  I 
wonder  it  never  occurred  to  authors  to  call  it  "  the  gout !"  seeing  there  is,  at 


112  LECTURE  V. 

least,  this  resemblanee  betwixt  them,  that  both  generally  become  developed 
during  or  after  middle  age. 

There  are  not  wanting  authors,  who  have  traced  an  analogy  betwixt  rheu- 
matism and 

Cutaneous  or  Skin  Disease — 

and  as  all  disorders  are  cousins-german  to  ague,  we  must  give  them  full  credit 
for  their  powers  of  observation — stating,  at  the  same  time,  our  readiness  to 
help  them  out  to  a  still  more  comprehensive  view  of  the  relationship  which 
subsists  betwixt  all  "the  various  genera  of  disease." 

What  a  fine  thing  to  be  able  to  master  the  cloud  of  ridiculous  distinctions 
and  definitions  by  which  Drs.  Willan  and  Bateman  have  contrived  to  dis- 
guise the  whole  subject  of  Cutaneous  Disorder  ;  to  distinguish,  for  example, 
psoriasis  from  Ifepra;  erythema  from  erysipelas,  diseases  only  differing  from 
each  ether  in  being  acute  or  chronic,  or  from  being  more  or  less  extens 
developed  ;  all,  too,  depending  upon  the  same  constitutional  unity  and  integ- 
rity of  state — all  more  or  less  amenable  to  identical  agency!  Most  truly. 
then,  has  my  Lord  Bacon  remarked,  "  Divisions  only  give,  us  the  husks  and 
outer  parts  of  a  science,  while  they  allow  the  juice  and  kernel  to  escape  in  the 
splitting."  What !  I  shall  be  asked,  is  erysipelas  or  rose,  nothing  more  than 
a  result  of  ague — erysipelas,  for  which,  according  to  Mr.  Lawrence,  we  must 
make  incisions  in  the  skin,  at  least  a  foot  long — gashes  not  quite  so  short,  but 
quite  as  deep  as  sabre  wounds !  Hear  what  Sir  James  Mackintosh  says, 
when  describing  his  own  case;  and  the  accuracy  of  his  description  will 
scarcely  be  questioned,  if  it  be  remembered,  that  previously  to  entering  upon 
his  legal  career,  Sir  James  had  not  only  studied,  but  taken  his  degree  in  physic : 
44  We  had  an  unusually  cheerful  day,"  he  says,  "  but  just  as  I  was  going  to 
bed  I  was  attacked  by  a.  Jit  of  shivering,  which  in  the  morning  was  followed 
by  a  high/ever,  and  in  two  days  by  an  erysipelas  in  the  face.  The  disease 
went  through  its  course  mildly,  but  it  is  liable  to  such  sudden  turns,  (fits  ?) 
that  one  is  always  within  six  hours  of  death."  For  the  value  of  quinine  or 
bark  in  this  disease,  I  could  cite  many  authorities,  but  the  candour  of  Mr. 
Travers  entitles  his  evidence  to  a  preference.  At  a  meeting  of  the  Medico- 
Chirurgical  Society,  he  is  reported  to  have  stated,  that  in  "a  great  many  in- 
stances [of  erysipelas]  he  had  found  the  most  decided  benefit  from  the  use  o( 
bark  and  other  tonics,  and  which,  at  the  commencement  of  the  disease,  he 
had  often  seen  highly  useful  in  the  practice  of  others,  even  in  cases  where  he 
would  have  employed  the  antiphlogistic  treatment,  if  the  patients  had  fallen 
into  his  own  hands." — Lancet. 

Every  medical  man  of  experience  knows  that  erysipelas  is  very  often  epi- 
demic ;  in  other  words,  it  prevails  at  a  particular  time  to  a  greater  or  less 
extent  among  a  particular  people  or  class  of  people.  Wherefore  it  seems  to 
depend  upon  a  particular  constitution  of  atmosphere  ;  for  during  the  time  it  is 
prevalent  in  camps  or  cities,  the  slightest  scratch  on  the  skin  will  set  it  up. 
I  have  known  it  follow  the  application  of  a  blister  to  the  chest ;  and  I  remem- 
ber, when  in  Edinburgh  Castle  with  the  Royals,  I  was  obliged  to  toll  the 
officer  commanding  the  troops  a  little  of  my  mind  upon  the  subject  of  corporeal 
punishment ;  one  poor  fellow  had  just  escaped  with  his  life  from  the  erysipelas 
brought  on  by  a  flogging.  But  even  at  periods  when  the  disease  is  not  epi 
deraic,  it  may  be  produced  by  any  one  of  the  thousand  things  that  daily  occur 
in  life.  Cold  and  wet  are  "frequent  causes ;  and  there  are  individuals  who 
cannot  take  mercury  in  any  shape  or  dose  without  being  liable  to  an  attack 
of  it ;  nevertheless,  I  have  myself  cured  many  cases  with  mercury.  The 
best  practice,  however,  is  to  treat  it  like  other  acute  fevers.  Begin  with 
emetics,  and  follow  them  up  with  arsenic  or  quinine ;  this  practice  will 
apply  to  all  acute  diseases  of  the  skin,  by  whatever  names  they 
known  or  distinguished. 

What  are  the  causes  of  Cutaneous  Disease  generally  ?     Everything  that 


LECTURE  V.  113 

can  set  up  fever  ;  and  what,  agent  in  nature,  when  abused,  may  not  do  that  ? 
Cutaneous  disease  may  be  produced  by  mechanical  injury  even — a  blow,  or 
a  fall,  for  example.  A.  friend  of  mine,  who  hunts  a  great  deal,  has  had  several 
falls  from  his  horse,  and  on  each  occasion  the  accident  was  followed  by  an 
eruption  all  over  his  skin.  I  have  known  eruptions  to  be  a  constant  effect  of 
the  introduction  of  a  bougie  into  the  urethra  of  a  particular  individual.  What 
will  the  gentlemen  of  the  Humoral  School  say  to  this  ?  for  you  know  the 
partisans  of  that  school  trace  all  such  diseases  to  a  "  morbid  ingredient  in  the 
blood,"  and  they  look  upon  eruptions  as  an  effort  of  nature  to  expel  the  "  pec- 
cant humour."  Be  careful,  they  tell  you,  not  to  drive  it  in  !  Now,  what  is 
an  eruption  but  the  effect  of  a  tendency  to  decomposition  of  the  matter  enter- 
ing into  a  detached  portion  of  the  cuticular  tissue,  so  as  to  produce  an  arrange- 
ment and  motion  of  the  atoms  composing  it  different  from  their  motion  and 
arrangement  in  health  ?  Such  caution,  therefore,  amounts  exactly  to  this  ; 
be  careful  that  you  do  nothing  that  shall  make  these  cuticular  atoms  resume 
their  respective  places  and  motions  in  the  economy,  so  as  to  resemble  the 
healthy  skin  !  See,  then,  to  what  a  ridiculous  pass  the  humoral  doctrine 
leads !  When  that  doctrine  was  more  prevalent  than  it  is  at  present,  cutaneous 
diseases  were  very  generally  classed  under  the  head  of  "  Scurvy,"  or  Scor- 
butic;  whoever  had  eruptions  on  his  skin  of  a  chronic  character  was  said  to 
have  the  scurvy.  Now,  if  this  phrase  had  been  used  simply  as  a  sign,  or 
"  counter  to  reckon  by,"  no  great  harm  could  have  ensued ;  but,  like  "  scrofula" 
and  the  "  gout,"  "-S'c?/nu/,"  in  process  of  time,  came  to  perform  the  part,  not 
of  a  sign  merely,  but  of  a  corporeal  something — an  indefinite  entity  or  essence 
— which,  like  a  will-o'-the-wisp,  played  its  "  fantastic  tricks"  now  in  this 
part  of  the  body,  now  in  that.  Some  wise  professor  made  his  pupils  sup- 
pose that  he  had  detected  it  in  the  blood  even  ;  and  from  that  moment,  not 
only  did  people  believe  that  scurvy  was  a  specific  disease,  but  the  whole 
faculty  were  anxious  to  discover  a  specific  remedy  for  it.  A  specific  for  what, 
Gentlemen  ? — for  an  airy  nothing,  that  only  existed  in  the  theoretic  visions 
of  their  own  most  mystified  brains.  You  may  stare  as  you  please  ;  but  this, 
after  all,  is  the  truth.  What,  then,  you  will  demand,  is  the  disease  which 
doctors  call  "  Ship-Scurvy  ?"  Having  myself  been  months  at  sea  without 
landing  or  seeing  land,  my  evidence  may  be  just  as  good  as  that  of  others  who 
have  handled  the  subject  before  me.  During  long  and  harassing  voyages, 
what  from  being  forced  by  foul  weather  to  sleep  under  closed  and  conse- 
quently unventilated  decks — what  from  being  obliged  to  watch  and  work 
hard  upon  a  short  allowance  of  food  and  water — together  with  the  anxiety 
and  depression  of  spirits  produced  by  "hope  deferred,"  the  men  gradually 
begin  to  show  signs  of  a  constitutional  "  break-up."  You  will  find  them 
with  faces  pale  and  bloated  ;  their  skins  rough,  rugged,  and  exhibiting  pete- 
chia and  haemorrhage  ulcers  ;  their  gums  weak,  spongy,  and  bleeding ;  their 
hair  harsh,  dry,  and  falling  away,  and  their  bowels  subject  to  fluxes ;  a  low 
Fever  wastes  them  day  by  day  and  night  by  night,  and  they  become  at  last 
so  ill  as  to  faint  from  the  least  exertion.  This  is  Ship- Scurvy — not  depend- 
ing upon  a  something  noxious  in  the  blood,  but  upon  a  positive  wan t  of  some- 
thing essential  to  itshealthy  reproduction.  And  how,  think  you,  is  this  dis- 
ease to  be  cured  ?  By  wholesome  food  and  pure  air,  you  will  naturally 
reply.  No  such  thing,  Gentlemen  :  nothing  so  simple  would  do  for  scientific 
people.  It  can  only  be  cured  by  Lemon  juice!  Lemon  juice,  according  to 
the  greatest  medical  professors,  is  not  only  a  preventive  of  the  bad  effects  of 
starvation,  but  a  substitute  for  pure  air  and  proper  food  in  the  cure  of  diseases 
produced  by  a  deprivation  of  both  !  Now,  it  is  a  curious  fact  in  the  history 
of  ship-scurvy,  that  just  about  the  time  that  lemon-juice  came  into  fashion, 
as  a  cure  for  it,  great  improvements  began  to  be  made  in  navigation,  as  also 
in  ship -building,  and  in  the  ventilating  and  victualling  of  fleets  ;  voyages  that 
formerly  took  up  a  year,  can  now  be  completed  in  a  month  or  two,  and  the 
natural  good  effects  of  all  this  upon  the  habits  and  constitutions  of  the  sea- 


114  LECTURE  V. 

men  are,  up  to  this  moment,  very  modestly  claimed  by  the  doctors,  as  the 
result  of  their  employment  of  lemon-juice.  And  not  only  are.  there  fools  in 
the  world,  but  philosophers  also,  who  daily  echo  this  trumpery  story  ! 

There  is  not  a  disorder  of  the  skin,  however  named,  that  I  have  not  seen 
cured  by  quinine;  and  I  have  met  with  examples  of  every  kind  of  skin-dis- 
eases, that  have  baffled  me  with  every  thing  I  could  thing  of.  I  may  here, 
nevertheless,  state  in  regard  to  cutaneous  disease  generally,  that  I  have  not 
very  often  been  at  a  loss,  while  I  had  at  my  disposal  quinine,  arsenic,  oxy- 
muriate  of  mercury,  hydriodate  of  potass,  creosote,  iron,  and  lead.  In  a  very 
obstinate  case  of  scald-head,  the  subject  of  which  was  a  young  artist  of 
talent,  a  combination  of  belladonna  and  stramonium  effected  a  complete  cure 
in  about  a  fortnight.  The  disease,  in  this  instance,  had  been  upwards  of 
twelve  months'  standing,  and  had  resisted  the  prescriptions  of  some  of  the 
ablest  men  of  Dublin  and  London.  Baths,  of  which  I  shall  afterwards  speak, 
T  have  also  found  of  great  service  in  diseases  of  the  skin  ;  but  what,  Gentle- 
men, do  all  these  remedies  come  to  at  last,  but  to  the  various  forces  that  pro- 
duce thermal  change  ? 

In  the  great  majority  of  instances,  then,  the  local  disorder  from  which  phy- 
sicians almost  invariably  name  disease,  and  to  which  they  almost  as  invari- 
ably confine  their  attention,  is  only  one  of  many  features  of  universal  disturb- 
ance. So  far  from  being  the  cause  of  such  disturbance,  the  local  tendencies 
to  disorganisation  are  merely  hereditary  or  accidental  developments  occur- 
ring in  its  course — developments  expressive,  for  the  most  part,  of  the  weak 
points  of  individual  constitution — though  sometimes  determined  by  climate  or 
other  speciality  of  cause.  In  England,  for  example,  the  viscera  of  the  chest 
are  the  organs  which  chiefly  suffer — while  in  the  East  and  West  Indies,  the 
liver  and  other  contents  of  the  abdomen  become  more  frequently  implicated. 
Remittent  fever,  I  need  not  say,  is  the  parent  of  both. 

Injuries,  passions,  poisons,  then,  are  each  capable  of  producing  the  same 
constitutional  disturbance  with  every  kind  and  degree  of  organic  change  to 
which  the  subjects  of  them  may,  by  original  weakness  of  configuration,  be 
predisposed.  To  use  a  homely  phrase — "  when  the  whole  house  shakes, 
the  worst-built  room  suffers  most" — and  this,  of  course,  differs  with  every 
house.  A  blow  on  the  head  ;  nay,  an  injury  to  so  minute  a  member  as  the 
finger,  may  produce  a  general  febrile  disorder,  ending  in  abscesses  of  the 
lungs  or  liver,  according  to  the  predisposition  of  the  patient.  Even  in  the 
course  of  the  contagious  or  pustular  fevers,  we  daily  find  all  sorts  of  organic 
change  developed — change  which  no  man  in  his  senses  would  place  in  the 
light  of  a  cavsc  of  those  fevers.  Among  the  organic  and  other  disturbances 
induced  by  the 

Small-Pox  Fever, 

*  or  Variola,  as  it  is  called  by  the  profession,  I  have  noticed  sore  throat, 
deafness,  dropsy,  consumption,  glandular  swellings,  rheumatism,  and  palsy  ; 
just  as  I  have  seen  the  same  localisms  developed  in  the  course  of  a  common 
remittent  fever  ;  such  consequences  depending,  of  course,  upon  the  original 
predisposition  of  the  patient  to  the  development  of  this  or  that  complaint,  bv 
any  agency  capable  of  injuring  the  general  constitution.  And  how  should  it 
be  otherwise,  when  we  come  to  reflect  that  the  small-pox  fever,  like  every 
other  fever,  consists  in  a  succession  of  paroxysms  bo  exactly  resemblin 
that,  before  the  appearance  of  the  eruption,  it  cannot  possibly  be  distinguished 
from  it!  Nor,  so  far  as  individual  treatment  is  concerned,  does  thai  matter 
one  straw  ;  for,  however  perfectly  specific  the  cauH  of  the  disorder  undoubt- 
edly is,  the  disease  admits  of  no  specific  treatment.  To  shorten  tin  i  old 
stage,  you  may  resort  to  the  Dearest  cordial  you  can  get.  During  the  hot, 
keep  ttie  patient  as  cool  as  possible,  or  endeavour  to  break  it  by  an 
which,  in  nine  times  out  of  ten,  you  may  easily  do;  and  when  that  and  the 
6weati.no  stage  are  ended,  endeavour  to  prolong  the  interval  of  remission  by 


LECTURE  V.  115 

opium,  hydrocyanic  acid,  or  quinine.  Such,  T  believe,  comprehends  nearly 
the  whole  duty  of  the  physician  in  this,  as  in  every  other  acute  disorder.  By 
a  reverse  course,  the  most  perfectly  curable  case  of  small-pox  may  be  very 
speedily  rendered  malignant.  During  the  spring  of  1824,  a  great  many  in- 
stances of  the  disease  occurred  in  Edinburgh  ;  and  I  remember  two  cases 
which,  from  the  difference  of  the  practice  employed,  and  from  the  difference 
of  the  results,  made  a  strong  impression  upon  my  mind.  The  first  case  was 
treated  by  the  late  Dr.  Mackintosh,  by  repeated  bleeding  and  purgation,  in 
consequence  of  which,  the  patient  ibecame  delirious,  and  the  pustules  were 
rendered  confluent.  The  subject  of  the  second  case  was  myself;  having  fre- 
quently visited  the  former  gentleman  during  his  illness,  I  may  fairly  presume 
I  took  the  infection  from  him.  But  the  treatment,  in  my  own  instance,  was 
restricted  to  an  occasional  antimonial,  and  an  opiate  about  seven  in  the  even- 
ing, which  had  the  effect  of  either  entirely  preventing  the  anticipated  par- 
oxysm, or  of  rendering  it  so  trifling  as  to  pass  without  observation.  On  two 
occasions  it  was  neglected,  and  a  night  'of  fever  and  restlessness  was  each 
time  the  result.  I  was  out  of  the  house  in  ten  days,  and,  as  you  see,  I  have 
not  a  perceptible  mark  on  my  countenance;  while  the  other  gentleman  was 
confined  to  his  room  for  more  than  a  month,  barely  escaping  with  his  life  ; 
and  when  he  made  his  appearance  in  the  streets,  his  face  was  so  disfigured 
by  scars,  his  most  intimate  friends  did  not  know  him  when  he  addressed 
them.  During  the  autumn  and  winter  of  1825,  while  I  attended  the  Pari- 
sian Hospitals,  the  small-pox  was  racing  fearfully  in  France.  But  so  un- 
successful was  the  treatment  employed — bleeding,  leeching,  and  purgation — 
that  the  dissecting-rooms  of  Paris  were  literally  crowded  with  the  bodies  of 
people  who  had  died  of  the  disease.  Some  of  these  bodies  bore  the  mark  of 
vaccination  on  their  arms.  But  what  is  vaccination  ?  Vaccination  is  only 
the  artificial  introduction  into  the  human  system  of  an  animal  poison  ;  and  it 
was  first  practised  by  Dr.  Jenner,  of  Berkeley,  in  Gloucestershire.  Now 
Jenner  was  a  man  of  great  observation — great  penetration — a  man  upon  whom 
facts  were  never  lost — not  a  mere  collector  of  facts — not  one  of  those  poor 
creatures  who  cry,  "  Facts,  facts,  give  me  facts — I  never  think" — men  who 
might  as  wisely  cry,  "  Bricks,  bricks,  give  me  bricks — I  never  build  !"  Of 
a  quite  different  stamp  was  Dr.  Jenner.  Practising  his  profession,  chiefly  at 
first  among  the  poor  of  his  native  county,  from  them  he  learned  that  many 
people  connected  with  dairies  had  their  hands  attacked  with  an  eruptive  dis- 
ease, which  they  traced  to  a  similar  eruption  on  the  teats  of  the  cows  they 
milked  ;  and  their  general  belief  was,  that  such  as  had  this  eruption  could 
not  take  the  small-pox.  All  through  Gloucestershire,  this  fact  was  known 
to  the  peasantry  ;  but  the  wise  doctors  only  looked  upon  it  as  a  popular  super- 
stition. Not  so  Jenner  ;  who,  on  setting  about  an  investigation,  discovered 
it  to  be  the  truth  ;  and,  in  spite  of  the  greatest  opposition  from  men  of  his  own 
profession,  and  others  whom  they  secretly  influenced,  he  finally  succeeded  in 
establishing  the  practice  of  vaccination ;  so  called  from  vacca,  the  Latin  for  cow. 
Jenner,  then,  was  the  first  who  artificially  introduced  cow-pox  as  a  preventive 
of  small-pox:  and  that  it  is  indeed  a  preventive  you  will  have  no  difficulty  in 
believing,  if  you  choose  to  recall  to  memory  the  number  of  persons  whose  faces 
were  fretted  and  seamed  by  the  small-pox  in  your  younger  days,  and  the 
few  instances  of  a  similar  kind  you  meet  with  in  these  times,  since  vaccina- 
tion has  been  practised.  Do  you  doubt  the  preventive  effect  of  small-pox 
against  a  recurrence  of  small-pox  ?  No  more  can  you  doubt  the  effect  of 
vaccination  ;  for,  though  small-pox  does  occasionally  attack  individuals  who 
have  previously  undergone  vaccination,  so  also  does  it  recur-occasionally  in 
persons  who  bear  the  indelible  marks  of  having  previously  suffered  from 
small-pox  itself.  What  is  the  Vaccine  disease  but  a  modification  of  small-pox  ? 
It  is  small-pox  in  a  milder  form,  a  fact  which  Jenner  suspected,  and  which 
Mr.  Ceely,  of  Aylesbury,  has  recently  proved  by  a  very  simple  experiment. 
He  first  inoculated  a  cow  with  the  matter  of  a  small-pox  pustule.     From  the  ' 


116  LECTURE  V. 

new  pustules  which  were  in  due  time  produced  in  that  animal,  he  took  mat- 
ter and  inserted  it  into  the  arm  of  a  child.  The  vaccine  or  cow-pox  pustule 
was  the  result !  and  these  experiments  he  has  several  times  repeated  with 
the  same  success,  in  the  presence  of  many  medical  men;  so  that  the  cause  of 
small-pox  in  man  (whatever  its  real  nature  be)  becomes  so  altered  in  its 
vaccine  or  cow  modification,  as  to  constitute  a  most  valuable  preventive 
against  the  severer  form.  What  is  the  nature  of  the  specific  agent  which 
produces  and  reproduces,  through  such  an  infinity  of  individuals,  an  effect 
so  generally  specific  ?  Can  it  be,  as  Linnaeus  thought,  of  an  animal-culine 
character  ?  or,  is  it  at  all  analogous  to  the  influence  produced  by  the  magnet 
on  iron  ?  which  metal,  you  all  know,  may,  from  the  contact  of  a  magnet,  be- 
come itself  magnetic.  These  are  the  most  probable  relations  in  which  the 
subject  may  be  viewed  ;  if,  indeed,  it  have  not  some  analogy  to  the  continua- 
tion and  reproduction  of  all  animal  life. 

There  are  a  few  questions  connected  with  this  subject,  which  I  confess 
myself  unable  to  answer.  Perhaps  the  ingenuity  of  some  of  you  may  solve 
them  for  me. 

1.  Why  is  small-pox,  when  directly  inoculated,  more  generally  mild  than 
when  taken  casually  by  infection  ? 

2.  Why,  after  vaccination,  have  we,  in  the  majority  of  cases,  only  one  pus- 
tule instead  of  many,  as  in  the  case  of  the  small-pox  ? 

3.  Why  is  the  cow-pox  not  infectious,  like  small-pox,  seeing  that  it  is  a 
mere  modification  of  identical  agency  ?  The  cow-pox,  so  far  as  we  know, 
can  only  be  communicated  by  direct  inoculation. 

4.  Has  the  protection  which  the  cou'-pox  and  the  small-pox  afford  to  the 
constitution  against  recurrence,  any  analogy  to  agricultural  exhaustion — to 
the  impossibility  to  obtain  more  than  a  given  number  of  successive  crops  of 
a  particular  herbage,  from  a  particular  soil,  in  a  given  period  of  years  ? 

But  the  small-pox  fever  is  not  the  only  fever  which  once  having  attacked 
an  individual  during  his  life,  for  the  most  part  renders  him  unsusceptible  of 
recurrence — all  the  truly  contagious  fevers  have  this  effect — chicken-pox, 
measles,  scarlet-fever,  hooping-cough,  seldom  affect  the  constitution  above 
once  in  life  ;  though  sometimes,  like  small-pox,  they  make  their  appearance 
twice,  and  even  three  times  in  individuals.  By  some  authors,  the  chicken- 
pox  has  been  supposed  to  be  a  modification  of  small-pox — an  opinion  to  which 
I  myself  lean — for  when  we  consider  how  remarkably  small-pox  becomes 
modified  after  vaccine  transmission,  we  can  scarcely  doubt  that  it  may  admit 
of  still  further  modifications,  by  passing  through  the  bodies  of  other  animals 
besides  the  cow.  This  much  is  certain,  that  every  one  of  the  contagious  dis- 
eases has  the  most  perfect  analogy  to  the  ague ;  seeing  that  all  have  remis- 
sions and  exacerbations  of  fever  more  or  less  perfect  in  kind,  and  that  all  are 
more  or  less  amenable  to  the  chrono-thermal  remedies ;  not  one  of  which 
remedies,  however,  possessing  such  specific  influence  over  them,  as  to  be  i  x- 
clusively  relied  upon  in  the  treatinent  of  any  case.  Is  not  this  the  best  of  all 
proofs  that  there  is  no  "  specific"  in  physic?  If  for  a  most  decidedly  specific 
disease  we  have  no  specific  remedial  agency,  how  can  we  possibly  expect  to 
find  such  for  any  one  of  the  great  family  of  disorders  which  may  be  produced 
by  anything  and  everything  that  can  derange  the  general  health  ?  Yet  Dr. 
Holland  hopes  that  medical  men  may  one  day  find  a  specific  for  gout,  and 
another  for  consumption ;  diseases  which  may  be  produced  and  cured  by 
any  agency  that  can  alter  the  moving  powers  of  particular  individuals  ! 

Is  the 

Plague 

an  intermittent  fever  !  The  ense  of  Corporal  Farrell,  as  detailed  by  Dr.  Cal- 
vert, in  the  Medico- Chirurgical  rransactietu,  will  be  a  sufficient  ana 

the  question  : — "  This  man  had  been  standing  in  the  sea  on  the  10th  0 
vember,  upwards  of  an  hour,  to  wash  and  purify  his  clothes:,  according  to  an 


LECTURE  V.  117 

order  to  that  effect.  On  coming  out  of  the  water,  he  was  seized  with  violent 
shivering  and  headache,  succeeded  by  heat  of  skin,  and  afterwards  by  sweat- 
ing, which  alleviated  the  distressing  symptoms.  On  the  following  day  the 
paroxysm  was  repeated.  He  was  permitted  to  remain  in  the  barracks  from 
a  belief  that  his  complaint  was  intermittent  fever .  The  next  day  his  fever 
returned  as  usual,  but  it  now  declared  itself  to  be  the  plague  by  a  bubo 
(glandular  swelling)  arising  in  the  groin,  while  the  seat  of  the  pain  seemed  to 
be  suddenly  transferred  from  the  head  to  that  part.  The  paroxysm  was  again 
followed  by  an  intermission  or  remission.  But  the  next  morning,  while  dress- 
ing himself  to  go  to  the  lazaret,  he  dropped  down  and  expired." 

Disputes  still  exist  as  to  whether  plague  be  contagious  or  not.  From  a 
perusal  of  the  evidence  laid  before  the  House  of  Commons,  as  well  as  from 
analogical  reasoning,  my  belief  is,  that  it  is  not  contagious  ;  but  on  whichso- 
ever side  truth  lies,  there  can  be  no  difficulty  as  to  the  proper  treatment. — 
The  indications  in  plague  as  in  simple  intermittent  fever,  or  the  small-pox, 
are  to  regulate  the  temperature  in  the  cold  and  hot  stages,  by  the  means 
already  pointed  out,  and  to  prolong  the  remission  by  quinine,  opium,  arsenic, 
&c,  according  to  particular  constitutions.  Treated  in  this  manner,  the  dis- 
ease could  not  by  any  possibility  be  more  fatal  than  we  are  told  it  is  under 
the  present  routine  of  practice.  "  In  all  our  cases,"  says  Dr.  Madden,  "  we 
did  as  all  other  practitioners  did ;  we  continued  to  bleed,  and  the  patients 
continued  to  die  !" — Madden's  Constantinople. 

From  the  same  candid  author,  I  find  that  the 

Yellow  Fever 

of  the  West  Indies,  is  not  less  remarkable  for  its  periodic  remissions  and  ex- 
acerbation than  for  the  shiverings  and  alterations  of  temperature  character- 
istic of  every  other  disorder.  The  yellow  appearance  of  the  patient,  like  the 
milder  jaundice  of  our  own  climate,  is  a  mere  effect  of  spasm  of  the  gall  ducts. 
Jaundice,  then,  is  a  symptom,  not  a  disease  ;  it  is  the  result  of  spasm  developed 
in  the  course  of  a  febrile  paroxysm.  People  will  say,  "  You  would  not  give 
quinine  or  bark  in  jaundice."  But  wherefore  not  ?  seeing  I  could  muster  a 
good  half-hundred  instances,  where  I  myself  have  cured  the  disease  by  one 
or  the  other.  Dr.  Madden  details  a  case  of  yellow  fever  cured  by  quinine, 
a  case  in  which  he  says,  "  had  the  gentleman  been  bled,  after  the  fashion  of 
the  country,  I  think  in  all  probability  he  would  have  died ;  or  had  he  survived, 
that  he  would  have  had  left  a  debilitated  constitution  and  a  dropsical  diathesis 
to  encounter  in  his  convalescence." 

Previous  to  my  embarkation  for  the  East  Indies,  where  it  was  my  chance 
to  serve  five  years  as  a  medical  officer  of  the  army,  I  read  Dr.  James  John- 
son's work  on  the  "  Diseases  of  Tropical  Climates."  Impressed  when  a  boy 
with  his  pretty  style,  I  put  his  sanguinary  treatment  and  his  twenty-grain 
doses  of  calomel  to  the  test.  But  so  far  from  confirming  his  assertions,  my 
own  after-experience  led  me  to  adopt  conclusions  much  the  same  as  Dr.  Mad- 
den. Captain  Owen  of  the  Royal  Navy,  too,  who  could  neither  have  a  theory 
to  support  nor  an  interested  end  to  serve,  one  way  or  the  other,  details  at 
great  length  the  mortality  which  took  place  among  his  people  while  employed 
in  surveying  the  African  coast.  "  It  may,  in  fact,  be  questioned,"  says  this 
intelligent  navigator,  "  whether  our  very  severe  losses  were  not,  in  some 
measure,  attributable  to  European  medical  practice,  Bleeding  and  Calomel 
being  decidedly  the  most  deadly  enemies  in  a  tropical  climate.  During 
the  whole  time  of  the  prevalence  of  the  fever,  we  had  not  one  instance 
of  perfect  recovery* after  a  liberal  application  of  the  lancet  or  of  this 
medicine."  Captain  Owen  further  states,  that  he  himself  recovered  without 
either  bleeding  or  calomel ;  while  the  ship-doctor  fell  a  martyr  to  his  medical 
faith  ;  he  bled  himself,  took  calomel,  and  died  !  [The  above  remarks  were 
first  printed  in  1840.     Two  years  afterwards,  12th  November,  1842,  Extracts 


118  LECTURE  V. 

from  the  Report  of  the  Select  Committee  on  die  Western  Coast  of  Africa,  ap- 
peared in  the  Twines  newspaper,  wherein,  among  other  things,  is  the  follow- 
ing :  "  The  bleeding  system  has  fortunately  gone  out  of  fashion,  and  the  fright- 
ful mortality  that  attended  its  practice,  is  now  no  longer  known  on  board  our 
ships." — Dr.  James  Johnson,  are  you  satisfied  ?] 

But  the  eastern  practitioner  will  tell  me  possibly,  that 

Dysentery 

cannot  be  safely  treated  in  any  other  fashion.  Is  he  sure  he  knows  exactly 
what  is  meant  by  the  word  dysentery  ?  I  shall  say  nothing  of  its  etymology, 
but  rather  give  you  the  symptoms  included  by  Sydenham  under  the  name. — 
"The  patient,"  he  tells  us,  "is  attacked  with  a  chilliness  and  shaking, 
which  is  immediately  succeeded  by  a  heat  of  the  body.  Soon  after  this, 
gripes  and  stool  follow."  What,  then,  Gentlemen,  is  this  dysentery  but  an 
ague,  with  increase  of  secretion  from  one  surface  instead  of  another  ;  from  the 
mucous  surface  of  the  bowels  instead  of  the  skin ;  and  the  skin,  remember, 
is  only  a  continuation  of  the  mucous  membrane  of  the  bowels.  Now,  Dr. 
dimming,  late  of  the  East  India  Company's  medical  service,  informs  us.  that 
while  ascending  the  Nile,  in  1836,  he  was  attacked  with  dysentery.  After 
suffering  for  a  week,  with  "  intervals  of  remission"  he  fairly  gave  himself  up, 
and  so  did  his  attendants,  for  he  had  nothing  in  the  shape  of  medicine  with 
him.  As  a  forlorn  hope,  however,  he  ordered  his  guide  to  sponge  him  with 
warm  water.  And  this  simple  remedy  (attention  to  temperature),  with  fomen- 
tation of  the  abdomen,  was  the  only  treatment  employed.  He  took  a  little 
wine  and  water,  which  remained  upon  his  stomach  ;  he  then  became  drowsy, 
slept  for  a  short  time,  felt  his  skin  less  hot  and  burning,  and,  in  brief,  began  to 
recover,  and  that  rapidly.  In  about  a  week  afterwards,  he  writes  in  his 
journal:  "My  recovery  is  almost  complete,  and  the  rapidity  of  my  conva- 
lescence leads  me  to  contrast  my  late  attack  with  a  precisely  similar  one  which 
I  had  at  Cawnpore  in  the  autumn  of  1829.  On  that  occasion,  I  was  largely 
bled  at  the  arm,  \md  fifty  leeches  applied  to  the  abdomen,  and  during  the  first 
four  days  of  the  disease,  in  addition  to  extensive  mercurial  frictions,  I  swal- 
lowed ttvo  hundred  and  sixteen  grains  of  calomel.  True,  I  recovered ;  or 
rather,  I  did  not  die !  whether  in  consequence,  or  in  spite  of  the  above  heroic 
treatment,  I  will  not  venture  to  say.  My  face  was  swollen  to  an  enormous 
size  ;  every  tooth  was  loose  in  my  jaws ;  and  for  six  or  eight  weeks  I  could 
eat  no  solid  food  ;  my  constitution  received  a  shock  from  which  it  never  fairly 
recovered,  and  I  was  obliged  to  come  to  Europe  on  furlough.  On  the  present 
occasion,  fortunately  for  me,  the  vis  medicalrix  natunc  was  my  sole  physi- 
cian, (he  forgot  the  sponging  part !)  and  I  am  now  almost  as  well  as  before 
the  attack  commenced.  British  medical  practice,  in  my  humble  OPI- 
NION, DEALS   TOO  MUCH   IN  HEROICS." 

That  opinion,  Gentlemen,  I  hope,  is  now  yours  also — it  has  many  year9 
been  mine.  Such  a  case,  from  such  a  quarter,  must  doubtless  be  more  than 
sufficient  to  warn  you  against  the  sanguinary  and  mercurial  practice  intro- 
duced into  the  East,  by  the  influence  of  Dr.  James  Johnson's  work  on  the 
Diseases  of  India.  What  an  idea,  to  break  down  by  the  lancet  and  mercury, 
to  salivation,  the  attractive  power  of  every  atom  of  the  body,  in  the  expec- 
tation of  thereby  strengthening  its  weakest  parts  ?  Does  this  savour  of 
madness,  or  does  it  not  ?  and  that,  too,  as  I  hinted  before,  madness  of  rather 
a  homicidal  kind  ? 

Dropsy. 

How  can  there  be  a  morbid  superabundance  of  any  secretion  without  a 
corresponding  change  of  temperature?  He  who  will  ri«idly  scrutinise  this 
disease  shall  find  that  the  same  shivering*  and  lever  which  precede  the  sweat 
of  ague,  usher  in  the  tumid  abdomen  and  swollen  legs  of  Dropsy.  Dropcy, 
then,  muy  be  termed  an  ague  with  inu-ard  sut<it.     That  it  is  a  ren 


LECTURE    V.  119 

disease  may  be  seen  by  the  palpable  diminution  of  the  swelling  on  particular 
days  ;  to  say  nothing  of  the  hopes  both  of  the  patient  and  physician  on  such 
days  being  excited  by  general  improvement  throughout.  How  should  the 
disease  be  treated  ?  Not,  according  to  modern  practice,  by  diuretics  and  su- 
dorifics  solely  ;  but  by  a  combination  and  alternation  of  these  remedies  with 
the  medicines  of  acknowledged  efficacy  in  that  most  perfect  type  of  all  di- 
seases, the  ague.  Of  cases  successfully  treated  by  me  in  this  manner.  I 
I  could  give  you  hundreds — but  to  what  purpose  ?  The  recital,  after  all, 
would  amount  to  little  more  than  a  mere  repetition  of  the  paroxysmal  symp- 
toms of  ague,  minus  the  sweating  stage  ; — that  stage  being  typified,  never- 
theless, by  the  cellular  watery  effusion,  or  by  the  morbid  increase  of  the 
natural  secretion,  which  lubricates  the  various  shut  cavities  of  the  body, 
The  remedies  and  the  results  were  such  as  I  have  already  stated  to  you. 
"What  other  proofs  do  you  want  of  the  unity  of  all  disorder  ?  The  Pay- 
master-Sergeant of  the  Royals  had  Dropsy,  which,  notwithstanding  the  usual 
treatment  by  diuretics,  purgatives,  &c,  was  daily  getting  worse,  when  Dr. 
Stephenson,  of  the  13th  Dragoons,  suggested  the  application  of  poultices  of 
lichen  vulgaris  to  the  loins.  From  that  day  the  amendment  was  rapid,  and 
the  patient  subsequently  got  well.  Now,  Gentlemen,  everybody  believed 
that  there  must  have  been  some  magical  virtue  in  the  lichen.  But  Mr. 
Brady,  the  surgeon  of  the  regiment,  thinking  that  the  plant  had  less  to  do 
with  the  cure  than  the  heat  which,  in  the  form  of  a  poultice,  it  produced, 
determined  to  try  poultices  made  with  rice,  in  a  case  exactly  similar.  The 
result  was  the  same — a  cure  ;  proving  how  right  he  was  in  his  conjecture. 
Since  I  entered  into  private  practice,  I  have  repeatedly  prescribed  poultices 
to  the  loins  with  advantage,  and  I  have,  also,  with  the  assistance  of  plasters 
of  pitch,  galbanum,  &c,  succeeded  in  curing  cases  of  Dropsy,  that  resisted 
every  kind  of  internal  remedy. 

Cholera, — 

the  scourge  of  nations — will  cholera  be  found  to  partake  of  the  same  univer- 
sal type  of  disease,  the  ague  ?  You  will  be  the  best  judges,  Gentlemen, 
when  I  draw  my  parallel.  While  in  India  I  had  ample  opportunities  for 
ascertaining  its  nature.  Tremulous  and  spasmodic  action  belong  equally  to 
Ague  and  to  Cholera  ;  vomiting,  or  nausea,  characterises  both.  The  ague 
patient  has  sometimes  diarrhoea  or  looseness  ;  oppression  at  the  chest,  and 
coldness  of  the  whole  body,  are  the  primary  symptoms  of  each.  The  in- 
creased flow  of  pale  urine,  so  often  remarked  in  ague,  is  an  occasional  symp- 
tom of  the  Epidemic  Cholera.  In  more  than  one  instance  of  cholera,  which 
came  under  my  observation  while  serving  in  the  east,  that  secretion  passed 
involuntarily  from  the  patient  a  short  time  before  death.  Suppression  of 
urine,  so  common  in  the  late  epidemic,  was  a  frequent  symptom  of  the  Wal- 
cherin  ague.  When  there  is  no  hot  fit  or  reaction,  death  is  usually  preceded 
by  a  sleepy  stupor  in  both.  You  have  ague,  too,  with  hot  skin  and  bound- 
ing pulse,  a  state  analogous  to  the  milder  forms  of  cholera,  in  which  you  re- 
mark the  same  phenomena.  When  not  fatal,  cholera,  like  ague,  has  a  hot 
and  sweating  stage.  Moreover,  when  ague  terminates  life  by  a  single  par- 
oxysm, you  find  the  same  appearances  after  death  in  the  bodies  of  both. 
Lastly,  frenzy,  disease  of  the  lungs,  liver,  and  spleen,  with  dysentery  and 
dropsy — to  say  nothing  of  epilepsy  and  apoplexy — have  been  the  occasional 
sequelae  of  each.  Cholera,  then,  is  an  extreme  of  the  cold  stage  of  ague. 
What  are  the  remedies  most  beneficial  in  Cholera  1  Attention  to  Tem- 
perature comprehends  everything  that  has  either  failed  or  succeeded.  Were 
I  myself  to  become  the  subject  of  it,  I  should  feel  inclined  to  trust  more  to  a 
bottle  of  brandy  than  to  anything  contained  in  the  Materia  Medica.  While, 
serving  in  the  East  Indies,  I  saw  many  hundred  cases  of  the  disorder,  but  I 
never  °could  convince  myself  of  the  superiority  of  any  one  kind  of  active 
medical  treatment  over  another.     In  my  work  upon  the  Diseases  of  India,  I 


120  LECTURE  V. 

have  proved  that  death,  in  the  great  majority  of  instances  of  Cholera,  takes 
place  from  a  palsy  of  the  pneumo-gastric  nerves — those  nerves  that  iniluence 
the  functions  of  the  lungs  and  stomach.  If  you  divide  these  nerves  in  the 
dog,  you  have  the  essential  symptoms  of  Cholera,  viz.  loss  of  voice,  vomit- 
ing, and  difficult  breathing  always — cramps  and  flatulence  frequently  ;  and 
the  animal  seldom  survives  the  third  day.  On  dissection,  you  find  the  ves- 
sels of  the  head,  lungs,  and  intestines,  filled  with  black  blood.  That  is  ex- 
actly what  you  find  on  opening  the  bodies  of  persons  who  have  died  of 
cholera.  Shortly  after  my  return  from  India,  Dr.  Wilson  Philip  read  a  paper 
at  the  Westminster  Medical  Society,  in  which  he  took  the  very  same  view 
of  cholera ;  but  wherein  he  forgot  to  say  that  his  views  of  the  disease  had 
every  one  of  them  been  anticipated  by  me,  in  a  paper  which  I  published  in 
the  Lancet  before  I  quitted  India. 


LECTURE  VI. 

present  state  of  medical   practice  in  england — dtspepsia hys- 
teria, and  hypochondria — insanity — effect  of  ligatures faint 

— congestion,  its  nature — infantile  convulsions. 

Gentlemen, 

After  a  long  intercourse  with  the  world,  and  a  rigid  examination  of  what, 
in  his  day,  was  called  its  wisdom,  the  great  Lord  Bacon,  musing,  doubtless, 
over  his  own  philosophical  discoveries,  thus  writes : — "  It  is  a  view  of  de- 
light to  stand  or  walk  upon  the  ghore-side,  and  to  see  a  ship  tossed  with  tem- 
pest upon  the  sea,  or  to  be  in  a  fortified  town,  and  to  see  two  battles  join 
upon  a  plain  ;  but  it  is  a  pleasure  incomparable,  for  the  mind  of  man  to  be 
settled,  landed,  and  fortified,  in  the  certainty  of  truth ;  and  from  thence  to 
descry  and  behold  the  errors,  perturbations,  labours,  and  wanderings  up  and 
down  of  other  men."  But,  Gentlemen,  however  exciting  this  kind  of  plea- 
sure be  to  him,  who  should  be  content  with  merely  making  a  discovery  to 
himself— the  making  of  it  public  has  its  drawbacks;  for  in  the  words  of 
Johnson,  "  whoever  considers  the  revolutions  and  the  various  questions  of 
greater  or  less  importance,  upon  which  wit  and  reason  have  exercised  their 
power,  must  lament  the  unsuccessfulness  of  inquiry,  and  the  slow  advances 
of  truth,  when  he  reflects  that  great  part  of  the  "labour  of  every  writer,  is 
only  the  destruction  of  those  that  went  before  him.  The  first  "care  of  the 
Builder  of  a  new  system,  is  to  demolish  the  fabrics  that  are  standing."  But 
how  can  you  brush  away  the  cobwebs  of  ages  from  the  windows  of  Truth, 
without  rousing  the  reptiles  and  insects  that  so  long  rejoiced  in  the  darkness 
and  secrecy  these  cobwebs  afforded  ?— the  bats  and  spiders,  to  whom  the  day- 
light is  death  !  Truth,  like  a  torch,  does  two  thing*  ;  not  onlv  does  it  open 
up  to  mankind  a  path  to  escape  from  the  thorns  and  briars  which  surround 
them  :  but  breaking  upon  a  long  night  of  ignorance,  it  betrays  to  the  eves  of 
the  newly-awakened  sleeper,  the  bandits  and  brigands  wfeo  have  beea  takiii" 
advantage  of  its  darkness  to  rob  and  plunder  him.  What  lias  Truth  to  ex- 
pect from  these  ? — What,  but  to  be  whispered  away  by  the  breath  of  calum- 
ny, to  be  scouted  and  lied  down  by  the  knaves  arid  fools  whom  interest  or 
intercourse  has  leagued  with  the  public  robber  as  his  partisans  ?  Who  will 
talk  to  me  of  conciliation  ?  Who  will  tell  me  that  mild  and  hum],  rat. ■  mea- 
sures ever  brought  over  such  implacable  enemies  to  the  ranks  of  their  des- 
troyer ;  or  that  robbers,  rioting  in  the  spoils  of  their  victim,  will  listen  to  the 
voice  of  the  charmer,  charm  he  never  so  wisely  .'  Surely  people  must  bo 
out,  of  their  senses,  who  imagine  that  any  exposition  of  Truth  will  lie  accept- 
able to  men  whose  emoluments  arc  chietlv  derived   from  a  course  of  Btadied 


LECTURE  VI.  121 

and  systematic  mystification — Professors,  who  lure  the  student  by  every 
possible  promise  to  their  schools,  and  when  once  in  their  net,  keep  him  there 
by  every  possible   artifice  and  pretext  which  collusion  and  corruption  can 
devise !  one  day  entangling  him  in  a  web  of  unmeaning  sophistry — another 
stimulating  him  to  waste  his  time  in  splitting  straws,  or  in  magnifying  hairs 
— now  encouraging  him  in  a  butterfly  chase  after  shadows — now  engaging 
him  in  a  wordy  and  worthless  disputation  with  his  fellows  !     How  is  that 
student  to  be  repaid  the  capital  of  time  and  money  he  has  expended  upon 
what  he  calls  his  education  ?     How,  but  by  deluding  and  mystifying  in  his 
turn  the  suffering  sick  who  apply  to  him  for  relief?    For  relief? — Vain  hope  ! 
Look  at  the  numbers  of  persons  who  live,  or  try  to  live  by  physic — doctors, 
surgeons,  apothecaries,  druggists,  cuppers,  nurses — and  ask  yourselves  how 
even  one  tithe  of  these  can  do  so,  but  by  alternately  playing  upon  the  pas- 
sions and  prejudices — the  hopes,  fears,  and  ignorance  of  the  public  ? — in  one 
case  inflicting  visits  too  numerous  to  be  necessary ;  in  another,  employing 
draughts,  mixtures,  or  measures,  too  expensive,  too  frequently  and  too  fruit- 
lessly repeated,  to  be  all  for  the  benefit  of  the  patient !     Think  you,  that  the 
members  of  the  medical  profession  are  different  in  their  feelings  from  every 
other  human  being — that  their  minds  are  so  constituted,  that,  under  the  most 
terrible  temptations,  they  can  so  far  set  at  defiance  the  stern  law  of  necessity, 
as,  in  their  present  crowded  and  starving  state,  to  receive  with  open  arms  a  sys- 
tem that  threatens  so  many  of  their  order  with  ruin  ?     Is  it  in  the  nature  of 
things  that  they  will  welcome  a  practical  improvement,  by  which  the  prac- 
titioner may,  in  a  few  hours,  cut  short  cases  and  chances,  which,  by  daily 
visitations,  or  by  three  draughts  a-day,  might  be  profitably  protracted  to  a 
month,  if  the  system  on  which  it  is  based  were  only  advocated  in  calm,  mel- 
lifluous, and  complimentary  language  ?     As  soon  may  you  expect  a  needy 
attorney  to  be  prevailed  upon  by  his  client's  tears  to  cut  short  a  chancery 
suit ;  or  the  master  of  a  sailing-smack  to  listen  patiently  to  the  praises  of 
steam ;  or  a  coach  proprietor  to  admit  the  safety  and  superiority  of  railroad 
over  coach  conveyance,  when  estimating  the  losses  they  shall  respectively 
sustain  by  the  too  general  use  of  the  superior  motive  power.     What  though 
the  present  condition  of  medical  practice  be  less  the  crime  of  the  profession, 
than  the  fault  of  the  legislature,  that  permits  men  clothed  with  collegiate  au- 
thority— professors,  enjoying  the  sanction  of  its  protection — annually  to  lure, 
by  misrepresentation  and  lying  promises,  thousands  of  credulous  and  unsus- 
pecting youths  into  a  path  strewed,   even  in  the  very  best  of  times,  with 
thorns   and  briars  innumerable  ?      Better  far  that  one-half  of  these  should 
at  once  abandon  a  walk  of  life,  where  the  competition  is  so  keen  and  close, 
that  comparatively  few  in  the  present  day  can  live  honestly  by  means  of  it 
— than,  that  they  should  hereafter  have  to  eat  their  precarious  bread,  at  the 
daily  and  hourly  sacrifice  of  their  own  honour,  and  their  patients'  interests. 
Who  will  tell  me  half-measures  will  be  of  any  avail,   under  circumstances 
like  these  ?     Gentlemen,  in  corrupt  and  difficult  times,  half-measures,  so  far 
from  succeeding,  have  either  been  taken  as  a  sign  of  weakness  in  the  cause, 
or  as  a  symptom  of  timidity  on  the  part  of  the  advocate.    Away,  then,  with 
half-measures  ! — away  with  the  idea  of  conciliating  men,  the  already  rotten 
tree  of  whose  sustenance  you  sap — the  long-cemented  system,  whose  exist- 
ence depends,  not  on  a  virtuous  adherence  to  nature  and  truth,  but  upon  a 
collusive  and  fraudulent   perversion  of  both  !     When  persons,  little  versant 
with  the  present  state  of  medical  affairs,   see  men  of  established  name  sup- 
porting a  system  of  dishonesty  and  error,  they  too  often  doubt  the  light  of 
their  own  reason.     "  Would  Dr.  So-and-so,"  they  ask,   "  and  Mr.  Such-a- 
one,  hold  this  language,  if  they  did  not  themselves  believe  it — men  so  respect- 
able, and  so  amiable  in  private  life  ?"     But  tell  these   simpletons,  that  Dr. 
So-and-so's  Bread  depends  upon  his  Belief—  that  Mr.  Such-a-one's  family 
must  fall  with  his  fading  fortunes,  if  the  father,  in  the  language  of  Hazlitt, 
"  ceased  to  support  that  which  he  had  so  long  supported,  and  which  supported 


122  LECTURE  VI. 

Aim" — and  you  bring  an  argument  which,  though  not  quite  convincing  in  it- 
self, will  at  least  compel  a  closer  investigation  of  the  system  it  is  your  wish 
to  expose  and  crush.  "  To  abandon  usurped  power,"  says  Robertson,  in 
his  History  of  Scotland,  "  to  renounce  lucrative  error,  are  sacrifices  which 
the  virtue  of  individuals  has,  on  some  occasions,  offered  to  truth  :  but  from 
any  society  of  men  no  such  effort  can  be  expected.  The  corruptions  of  so- 
ciety, recommended  by  common  utility,  and  justified  by  universal  practice, 
are  viewed  by  its  members  without  shame  or  horror ;  and  reformation  never 
proceeds  from  themselves,  but  is  always  forced  upon  them  by  some  foreign 
hand."  Gentlemen,  I  have  been  blamed  for  the  tone  and  spirit  in  which  I 
have  spoken  of  my  adversaries — I  have  been  asked,  Why  assail  their  motives 
— why  not  keep  yourself  to  their  errors  ?  But  in  this  particular  instance,  I 
have  been  only  the  humble  imitator  of  a  great  master — a  man  whose  name 
will  at  once  call  up  every  sentiment  of  veneration — the  indomitable  Luther. 
Magnis  componere  parva,  I  have  followed  in  his  wake — I  hope  soon  to  add, 
passibus  cequis.  Think  you,  the  Reformation  of  the  church  could  have  pro- 
gressed with  the  same  rapidity,  had  its  most  forward  champion  been  honey- 
mouthed— had  his  lip  been  all  smiles,  and  his  language  all  politeness ;  or  had 
he  been  content,  in  pointless  and  unim passioned  periods,  to  direct  atten- 
tion solely  to  the  doctrinal  errors  of  Rome  ?  No ;  he  thundered,  he  denounced, 
he  heaped  invective  upon  invective,  and  dealt  in  every  form  of  language 
which  could  tell  best  against  his  enemies,  whether  in  exposure  or  attack. — 
Too  wise  to  leave  them  the  moral  influence  of  a  presumed  integrity,  they 
were  far  from  meriting,  he  courageously  tore  away  the  cloak  of  sanctity  and 
sincerity,  with  which,  in  the  eyes  of  the  vulgar,  they  had  been  too  long  .in- 
vested. Had  he  done  otherwise,  he  might  have  obtained  the  posthumous 
praise  of  moderation,  at  the  price  of  defeat  and  the  stake. 

Gentlemen,  let  it  not  for  a  moment  be  supposed,  that  in  thus  sweepingly 
arraigning  the  present  system  of  medical  policy,  I  have  the  remotest  wish  to 
degrade  the  profession  of  the  physician:  It  has  ever,  on  the  contrary,  been 
my  object  to  improve  the  social  position  of  my  order;  to  render  it  useful, 
honourable,  and  honoured,  that  kings  may  still,  as  they  once  did,  choose  their 
counsellors  from  it.  Nor  is  it  mv  wish  for  an  instant  to  insinuate  that,  among 
the  individual  members  of  the  profession,  there  are  not  numerous  exceptions 
to  the  line  of  conduct  too  generally  pursued.  In  every  one  of  its  grades  and 
conditions — apothecary,  surgeon,  and  physician — I  have  had  the  pleasure  to 
meet  gentlemen  who  not  only  heartily  join  me  in  deploring  the  present  shame- 
ful state  of  practice,  but  who  aid  me  with  their  best  efforts  to  expose  and 
correct  it.  One  and  all  of  these  honourable  persons  acknowledge,  that,  un- 
less some  great  and  speedy  change  in  the  mode  of  educating  and  remunerating 
medical  men  be  introduced  by  the  legislature,  medicine  must  shortly  cease  to 
be  regarded  in  the  light  of  a  liberal  profession  ;  for  as  things  now  stand,  the 
only  sure  path  to  lucrative  popularity  in  physic  is  a  complete  sacrifice  of  con- 
science and  principle  on  the  part  of  the  physician.  How  often  have  I  been 
told,  in  my  own  case,  that  by  courting  the  apothecary,  and  offering  up 
incense  at  the  false  shrine  of  the  professors,  I  might  easily  and  cheaply  obtain 
the  bubble  reputation,  to  be  blown  me  by  theirbreath  ;  while,  by  exposing 
the  intrigues  of  the  schools,  and  the  collusions  and  corruptions  of  i!k  profes- 
sional world,  not  only  do  I  stand  as  one  man  to  a  host,  but  I  lay  myself  open 
to  the  secret  stabs  of  a  thousand  unseen  assassins  !  To  tempters  of  that 
sort,  this  has  been  my  answer ;  let  it  be  yours  also — 

Slave!  I  have  put  mv  life  upon  a  cnst, 
And  I  will  stand  the  basard  St  the  die  ! 

That  hazard  now,  thank  heaven,  is  small.  The  daily  increasing  number  of 
upright  and  honourable  practitioners  who  espouse  my  views,  place  nit  already 
sutficietitly  far  above  the  reach  of  my  enemies,  to  enable  Die  to  despise  them 
thoroughly  :  and  at  this  moment  I  feel  as  secare  of  victory,  as  at  any  one 
period  of  my  life  I  feared  defeat !     As  yet,  I  have  only  assailed  the  system — 


LECTURE  VI.  123 

carefully  avoiding  individual  attack.  True,  I  have  repelled  the  attacks  of 
others,  somewhat  strongly,  too  ;  but  that  was  in  self-defence.  If  in  tearing 
away  the  veil  of  iniquity,  I  have  not  altogether  remained  unscathed,  I  have, 
at  least,  the  satisfaction  to  know,  that  my  enemies  have  done  everything  but 
laugh  at  the  blows  I  dealt  them.  If  it  be  said,  I  have  used  language  too 
strong  for  the  occasion,  I  answer  in  the  words  of  Burke  :  "  When  ignorance 
and  corruption  have  usurped  the  professor's  chair,  and  placed  them- 
selves in  the  seats  of  science  and  virtue,  it  is  high  time  to  speak  out.  We 
know  that  the  doctrines  of  folly  are  of  great  use  to  the  professors  of  vice.  We 
know  that  it  is  one  of  the  signs  of  a  corrupt  and  degenerate  age,  and  one  of 
the  means  of  insuring  its  further  corruption  and  degeneracy,  to  give  lenient 
epithets  to  corruptions  and  crimes."  What  reformer  has  not  been  called  a 
"  violent  person  ?"  none  that  I  ever  heard  of.  Now,  Gentlemen,  to  the  more 
orthodox  matter  of  this  lecture. 

We  have  hitherto  spoken  of  the  brain  as  a  unity  ;  yet  this  organ  is  divided 
into  two  hemispheres.  Like  the  features  of  the  face,  it  is  two-fold.  We 
have  two  eyebrows,  two  eyes,  two  nostrils,  two  ears,  and  in  the  early  foetal 
state,  the  mouth  and  chin  are  separated  in  the  middle  ;  you  have  the  marks 
of  this  original  separation  in  the  infant ;  I  may  also  say  in  the  adult.  Now, 
though  a  man  may  lose  one  eye,  he  is  not  therefore  blind ;  or  though  he  lose 
the  hearing  of  one  ear,  he  is  not  necessarily  deaf.  It  is  just  possible  that  a 
small  ])art  of  one  of  the  hemispheres  of  the  brain  may,  in  like  manner,  be- 
come diseased,  and  the  subject  of  it  shall  appear  to  reason  very  fairly  to  the 
last.  But  that  must  be  a  shallow  observer,  indeed,  who  from  such  a  possible 
fact  should  draw  the  fictitious  inference,  that  even  one  hemisphere  of  the 
brain  may  be  disorganized  throughout  its  entire  substance,  without  the  intel- 
lectual powers  being  at  all  disturbed  !  If  you  read  of  such  facts,  set  them 
down  as  false  facts.  The  brain,  then,  like  the  body,  in  some  of  its  parts  is 
double,  yet  like  the  body  in  its  integrity,  the  brain  is  a  unity,  and  like  the 
same  body  it  has  also  a  diversity'of  parts.  That  the  scalpel  has  hitherto 
failed  to  trace  any  well-marked  divisions  betwixt  the  various  cerebral  por- 
tions to  which,  phrenologists  have  ascribed  variety  of  function,  is  no  argument 
against  this  doctrine.  Do  not  all  the  different  parts  of  the  frame  merge  into 
each  other,  the  elbow  into  the  arm,  the  arm  into  the  hand,  &c.  ?  What  is 
more  clearly  a  unity  than  the  hand  ?  Yet  do  we  not  frequently  find,  from 
the  weakness  of  one  or  more  of  its  joints  or  muscles,  an  inability  on  the  part 
of  its  possessor  to  do  a  particular  work,  though  he  may  still  accomplish  many 
others  by  means  of  it  ?  It  is  the  same  thing  with  the  head.  Partial  disease 
of  the  brain  produces  partial  intellectual  injury,  and  you  see  the  effects  of 
such  injury  in  those  persons  who  reason  rightly  upon  every  subject  but  one, 
"  monomaniacs,"  as  they  are  called.  Oh  !  I  want  no  better  proof  of  diversity 
of  parts  in  the  brain  than  this.  Like  every  other  organ,  the  brain  of  man  com- 
mences its  fetal  existence  in  the  lowest  type  of  the  same  organ  of  those  ani- 
mals that  possess  a  brain,  gradually  assuming,  by  additions  and  superadditions, 
the  form  of  the  infant  brain.  In  some  instances,  as  in  the  case  of  other  organs 
of  the  body,  one  or  more  of  these  superadditions  are  never  properly  developed. 
The  result  you  can  anticipate  : — Idiocy,  according  to  the  degree  and  locality 
of  the  defect ;  and  yet  there  are  medical  twaddlers  who  have  the  audacity  to 
deny  that  the  brain  is  the  organ  of  intellect !  Were  their  statements  correct, 
why  confide  the  treatment  of  mental  derangement  to  the  physicians — to 
men  who,  for  the  cure  of  mental  derangement,  employ  the  identical  material 
agency  by  which  they  profess  to  cure  a  diseased  limb,  or  other  injured  mem- 
ber of  the  material  body  1  You  might  as  well  talk  cf  "  walking"  apart  from 
the  matter  of  the  legs,  as  of  mind  or  thinking  power  apart  from  the  matter  of 
brain  !  This  much  I  have  thought  it  right  to  premise  before  entering  upon 
the  subject  of 

Dyspepsia  or  Indigestion  ; 

for  to  the  state  of  the  brain  and  nervous  system,  we  shall  have  to  ascribe  the 


124  LECTURE  VI. 

disease.  When  treating  of  pulmonary  consumption,  at  a  former  meeting,  T 
explained  to  you  that  no  individual  could  possibly  suffer  from  any  complaint 
whatever,  without  his  digestion  being  more  or  less  implicated.  'The  patient 
who  labours  under  any  severe  form  of  disease,  such  as  gout,  consumption, 
or  erysipelas,  has  all  the  symptoms,  or  shades  of  symptom,  that  medical  men 
group  together  under  the  head  of  Indigestion  ;  but  the  superadded  symptom 
which,  from  its  prominence  or  locality,  may  dispose  the  physician  to  term  the 
disease  consumption,  erysipelas,  or  gout,  may  also  dispose  him  to  overlook, 
or  esteem  as  insignificant,  the  coincident  errors  and  disorders  of  the  digestive 
apparatus.  In  the  lower  and  more  subdued  forms  of  fever,  the  patient  very 
often  lias  no  particular  tendency  to  decomposition  in  any  organ  or  locality; 
but  from  every  function  being  more  or  less  wrong,  he  very  naturally  turns 
his  attention  to  his  stomach  or  bowels,  the  errors  of  which  come  more  parti- 
cularly under  the  immediate  cognisance  of  his  feelings.  Such  a  patient  will 
complain  to  you  of  flatulency  and  acidity,  or  of  that  distressing  symptom 
termed  "water-brash."  If  you  ask  him  about  his  appetite,  he  will  tell  you 
it  is  "  so-so  ;"  or  "  he  cares  nothing  about  eating ;"  or  it  is  positively  "  excel- 
lent"— which  last,  I  need  scarcely  tell  you,  means  that  it  is  morbidly  craving. 
Ten  to  one,  it  is  capricious — the  patient  now  wishing  for  this,  and  now  for 
the  other,  and  rejecting  what  he  desired  most,  the  moment  it  comes  before 
him.  Perhaps  he  has  thirst.  He  is  wearied  upon  the  least  exertion  ;  has 
little  inclination  to  get  up  in  the  morning,  and  when  he  does  get  up,  he  is  in- 
dolent, and  dawdles  his  time  away.  He  is  apathetic  in  mind  as  he  is  indolent 
in  body  ;  and  he  has  often  a  great  disposition  to  sleep,  especially  after  meals. 
Others,  again,  will  just  be  the  reverse  of  all  this ;  these  perpetually  harp 
upon  some  particular  topic — fidget  themselves  and  every  body  else  about 
trifles,  and  look  always  at  the  dark  side  of  life.  Some  fly  in  a  passion  for 
nothing,  or  upon  the  least  contradiction,  and  in  a  few  minutes  after  the  gust 
of  passion  has  passed  away,  they  lament  their  mental  weakness.  Their  nights 
are  either  sleepless  or  broken  and  disturbed  by  unpleasant  dreams.  One 
moment  they  dream  of  robbers,  from  whom  they  cannot  escape  ;  or  they  are 
on  the  eve  of  tumbling  down  a  precipice  ;  dreaming  sometimes  within  a  dream 
— asking  themselves,  even  in  the  very  act  of  dreaming,  whether  they  dream 
or  not — and  they  will  satisfy  themselves  by  a  process  of  unreason,  that  thev 
are  actually  awake  and  walk  the  air. .  Even  during  the  day,  many  of  these 
patients  have  their  dreams  or  reveries — pleasurable  sometimes,  but  more  often 
the  reverse  ;  they  see  things  either  as  "  through  a  glass  darkly,"  or  their 
perceptions  are  all  exaggerated  and  unnatural.  Phantoms  may  even  pass  be- 
fore them  at  mid-day,  phantoms  such  as  they  see  in  their  dreams  of  the  night. 
The  very  colours  of  things  may  be  altered  to  their  eyes — red  appearing  to 
them  green,  and  vice  versa.  Even  the  shapes  and  dimensions  of  bodies  may 
be  quite  changed  to  their  sight — though  the  greater  number  have  sufficient 
judgment  remaining,  to  know  this  to  be  an  optical  delusion  merely.  John 
Hunter  had  the  sensation  that  his  own  body  was  reduced  to  the'size  of  a 
pigmy  !  I  have  met  with  some  patients  who  have  even  at  times  doubted  their 
own  existence.  Light  and  shade  have  wonderful  effects  upon  most  invalids 
of  this  class.  One  is  perfectly  miserable,  except  when  he  is  in  Che  sunshine; 
another  cannot  bear  the  light  at  all.  Ringing  in  the  ears,  or  partial  dea&ew, 
is  a  common  complaint  of  dyspeptic  persons.  Some  can  only  hear  distinctly 
during  the  noise  of  passing  carriages,  or  in  the  hum  of  a  city,  or  of  falling 
Waters  ;  while  the  ears  of  others  are  so  sensitive,  they  complain  of  the  tick- 
ing of  the  clock.  The  sense  of  touch  is  very  often  similarly  vitiated;  one 
patient  having  partial  or  general  numbness;  another,  his  feelings  BO 
that  he  shrinks  with   pain  if  you  merely  touch  him.     Occasionally,  though 

arely,  you  have  examples  of  a  reverse  kind  :  the  patient  in  that 
will   iay,  "  Oh,  do  not  take  your  hand  away,  the  pressure  does  me  good — it 
acts  like  magnetism." 

All  kinds  of  aches  arc  complained  of  by  dyspeptic  patients — headache  per- 


LECTURE  VI.  125 

haps  most  frequent — headache,  for  which,  on  the  hypothetical  assumption  of 
fulness  of  blood  in  the  brain,  the  leech,  lancet,  and  cupping-glass,  are  so  fre- 
quently in  requisition.     But  to  what  end  ?     In  the  words  of  Abernethy,  sup- 
posing such  assumption  to  be  correct,  M  Does  blood-letting  cure  diseases  in 
which  there  is  a  fulness  of  blood  in  the  head  ?     It  must  be  granted,  that  in 
many  instances,  it  temporarily  alleviates  them,  but  in  others,  it  fails  to  relieve, 
and  even  aggravates  them."     What  are  those  headaches,  those  night  and 
day  dreams,  all  those  various  signs  and  sensations,  but  the  effects  of  a  great 
instability  of  brain,  now  brought  on  by  one  thing,  now  by  another  ?     I  have 
known  the  most  severe  and  distressing  headaches  arise  from  loss  of  blood,  and 
I  have  known  them  originate  in  a  long  fast.     Surely  for  such  diseases,  the 
leech  and  the  lancet  are  not  the   proper  remedies.     But,  Gentlemen,  there 
are  many  other  ways  by  which  the  brain  may  be  weakened.     You  may  as 
certainly  exhaust  it  by  prolonged  literary  or  other  mental  labour,  as  by  star- 
vation or  loss  of  blood  ;  for  there  are  times  to  think,  and  times  to  cease  think- 
ing ;  and  if  the  brain  be  eternally  harassed  by  an  over  anxiety  in  any  of  the 
pursuits  of  life  ;  if  it  be  always  at  work  on  one  subject,  not  only  will  there  be 
headache,  or  confusion  of  head,  but  the  constitution  must  be  injured.     How 
can  this  organ  painfully  revolve  again  and  again  the  occurrences  of  the  exter- 
nal world,  and  give  the  proper  attention  to  the  internal  economy,  over  which 
it  presides  ?     When  you  listen  to  an  orator  or  a  preacher,  whose  discourse 
powerfully  affects  you,  the  brain  becomes  so  engaged,  that  it  cannot  at  the 
same  time  attend  to  the  breathing;  and  you  are,  therefore,  compelled  ever 
and  anon  to  draw  a  long  breath ;  you  must  take  a  deep  sigh,  to  make  up  for 
the  ordinary  succession  of  short  inspirations  and  expirations,  which  constitute 
the  natural  art  of  breathing.     Now,  Gentlemen,  if  the  function  of  the  lungs 
be  so  easily  disturbed  in  this  way,  can  you  doubt  that  the  heart,  stomach, 
bowels,  and  other  parts,  may  be  similarly  influenced  1     What  are  the  com- 
plaints of  men  who  have  much  on  their  minds,  bankers,  merchants,  and  great 
lawyers  ?  what  the  diseases  of  aged  persons — persons  whose  brains  become 
weaker  and  weaker  by  the  slow  but  certain  operation  of  time  ?     Do  not  these 
patients  constantly  complain  of  their  stomach  and  bowels  ?     Do  not  many  of 
them  suffer  from  palpitations  of  the  heart ;  from  giddiness  and  sensations  like 
fainting,  with  a  fear  of  falling  1     Now,  Gentlemen,  this  giddy  sensation,  this 
disposition  to  fall,  is  most  commonly  felt  upon  suddenly  raising  the  head,  or  in 
rising  from  a  chair.     What  surer  sign  of  cerebral  weakness  ?     Yet,  not  long 
since,  two  gentlemen,  each  upwards  of  seventy,  informed  me  they  had  been 
bled  and  leeched  by  their  respective  apothe'caries,  for  this  disease  of  pure  cere- 
bral exhaustion.     Bless  my  life,  you  may  bleed  or  purge  a  healthy  man  into 
this  state  any  day  ! 

In  these  diseases,  one  patient  will  tell  you,  he  is  troubled  by  a  feeling  of 
sinking  and  pain  of  stomach,  which  is  only  relieved  by  eating.  Another  suf- 
fers from  spasm,  and  pain  of  the  heart  or  stomach,  with  acidity  or  flatulence, 
the  moment  he  begins  to  eat ;  and  in  either  of  these  cases  the  pain  may  some- 
times become  so  violent,  that  if  it  did  not  soon  go  off,  the  patient  must  die. — 
Now,  this  kind  of  spasm,  whether  affecting  the  stomach  or  heart,  is  a  disease 
for  which  you  are  expected  to  give  immediate  relief,  and  nothing  will  do  so 
more  readily  than  a  glass  of  hot  water — water  as  hot  as  the  patient  can  pos- 
sibly drink  it.  This  point  of  practice  we  owe  to  John  Hunter,  who,  having 
frequently  suffered  from  spasm  of  the  stomach,  tried  every  thing  he  could 
think  of,  and  among  others  hot  water.  The  ease  which  this  gave  him,  led 
him  to  extend  its  use  to  his  dyspeptic  patients  ;  and  my  own  experience  of  its 
virtues,  enables  me  to  bear  him  out  in  the  encomiums  he  has  passed  upon  it. 
To  this  simple  means,  palpitation,  spasm,  headache,  wind,  and  acidity,  will 
all  sometimes  yield  as  to  a  charm.  Is  not  this  another  instance  in  proof,  how- 
mere  change  of  temperature  acts  on  the  body  under  disease  ?  Now,  as  hy- 
drocyanic acid  very  frequently  gives  the  same  immediate  relief  in  every  one 
of  these  affections,  we  at  once  see  that  its  medicinal  power  must  depend  upon 


126  LECTURE  VI. 

the  change  of  temperature  which  it  electrically  produces.  Of  the  various 
cordials  to  which  you  may  have  recourse,  for  spasmodic  pain  of  the  heart  or 
stomach,  there  is  none  so  good  as  Noyeau  ;  and  the  virtue  of  this  "  strong 
water"  depends  very  much  upon  the  prussic  acid  it  contains.  Of  all  the  re- 
medies with  which  I  am  acquainted,  there  is  none  equal  to  this  acid,  in  con- 
vulsions and  spasms  of  every  kind.  But  spasms  of  the  stomach  and  heart 
are  not  the  only  ones  of  which  dyspeptic  patients  complain.  Some  are 
troubled  with  a  sense  of  tension  of  the  brain  ;  others  with  a  tightness  of  the 
throat  or  chest ;  and  some,  particularly  females,  suffer  from  a  spasmodic  affec- 
tion of  the  gullet,  which  gives  them  a  feeling  as  if  they  had  a  ball  there. — 
Others  are  subject  to  stitch  or  pain  of  the  side,  produced  by  cramp  of  the 
muscles  of  the  ribs.  How  correctly  Shakspeare  described  the  nature  of  these 
pains,  when  he  made  Prospero  say  to  Caliban  in  the  Tempest — 

For  this  be  sure,  to-night  thou  shalt  have  cramps, 
Side-stitches,  that  shall  pen  thy  breath  up  ! 

The  common  practice  in  these  cases  is  to  say,  "  Draw  your  breath  ;"  and 
if  you  cannot  do  so  for  the  pain,  "  inflammation"  is  the  imaginary  goblin  of 
the  doctor,  and  blood-letting  in  some  of  its  form's  the  too  ready  remedy  to 
which  he  flies  ;  how  vainly  for  the  patient — how  profitable  for  himself, 
truth  must  one  day  tell !  To  small  doses  of  nitrate  of  silver,  prussic  acid,  or 
quinine,  such  pains  will  often  yield,  after  having  resisted  every  form  of  de- 
pletion, with  all  the  usual  routine  of  blisters,  black  draught,  and  blue  pill  to 
the  bargain.-  The  great  error  of  both  patient  and  practitioner,  in  dyspeptic 
cases,  is  to  seize  upon  some  of  the  most  prominent  features  as  the  cause  of  all 
the  others.  In  one  instance,  they  will  blame  wind  ;  in  another,  acid.  But 
these,  as  it  happens,  instead  of  being  causes,  are  only  the  common  and  coin- 
cident effects  of  a  great  cerebral  weakness  ;  they  are  not  the  product,  as  many 
imagine,  of  fermentation  of  the  food — they  are  morbid  secretions  from  the 
lining  membrane  of  the  alimentary  canal.  And  of  this  you  may  be  assured, 
not  only  by  the  mode  of  their  production,  but  by  the  manner  of  their  cure,  when 
that  happens  to  be  accomplished.  Just  watch  a  dyspeptic  patient  when  he 
receives  a  sudden  or  unexpected  visit ;  his  "  heart-burn,"  as  he  calls  his 
acidity,  comes  on  in  a  moment,  and  his  bowels  commence  tumbling  and 
tossing  about,  and  will  often  guggle  so  audibly,  as  to  make  even  the  by- 
standers feel  sorry  for  him  ;  showing  you  clearly  that  this  acidity,  as  well 
as  the  gases  so  suddenly  extricate^,  are  the  effects  of  a  weakened  nervous 
system  ;  that  they  are,  in  a  word,  the  common  effects  of  wrong  secretion. — 
Now,  the  term  secretion  is  so  constantly  associated  in  the  mind  of  the  student 
with  the  notion  of  a  liquid,  that  some  of  you  may  not  all  at  once  comprehend 
how  gas  can  be  secreted  ;  but,  Gentlemen,  is  not  every  tissue  of  the  body 
the  result  of  secretion  ?  are  not  the  hair  and  the  nails  as  certainly  secreted  as 
the  saliva  or  the  bile?  Only  place  your  naked  arm  for  a  few  minutes  under 
water,  and  you  find  bubbles  of  air  constantly  forming  upon  it ;  such  air  being 
in  that  case  actually  secreted  before  your  eyes  by  the  glandular  apparatus  of 
the  skin  !  Can  you  be  at  any  difficulty  now,  to  conceive  how  flatus  is  a 
secretion  from  the  alimentary  canal?  If  a  doubt  remain,  you  have  only  to 
debilitate  the  brain  of  an  animal  by  bleeding  him  slowly,  and  his  bowels 
will  become  full  of  flatus,  even  to  bursting.  Then  again,  as  regards  ihe  cure 
of  dyspeptic  patients,  a  drop  or  two  of  prussic  acid,  twice  or  thrice  a-day  for 
a  week,  or  a  short  course  of  treatment  by  quinine,  nitrate  of  silvrr,  ur  alter- 
nations and  combinations  of  these  medicines,  will  often  do  away  for  months, 
and  even  years,  with  every  symptom  of  wind  and  acidity ;  while  cordials, 
alkalis,  and  mild  laxatives,  seldom  do  more  than  give  a  temporary  relief!— 
Oh  !  I  never  saw  much  good  done  by  that  placebo  mode  of  practice  ;  nor  is 
this  at  all  to  be  wondered  at,  if  you  reflect,  that  every  part  of  the  constitution 
of  a  dyspeptic  patient  is  more  or  less  disordered.  In  every  case  of  this  kind 
there  is  an  unnatural  temperature  of  body ;  some  patients  complaining  to 


LECTURE  VI.  127 

you  of  chills  or  heats,  or  alternatious  of  both  in  the  back,  stomach,  hands, 
feet,  &c.  In  these  cases,  the  skin,  partially  or  generally,  is  either  more  moist 
than  in  health,  or  it  is  harsh  and  dry  ;  perspiring,  if  at  all,  with  difficulty. — 
In  the  latter  case,  some  other  secretion  may  be  morbidly  active.  The  urine 
or  the  bile  may  be  in  excess  ;  or  the  natural  fatty  or  watery  deposit  of  the 
great  cavities  of  the  chest  and  abdomen,  may  be  in  superabundance.  The 
looker-on  may  even  have  a  false  impression  of  the  patient's  case  and  condi- 
tion, from  the  increase  of  either  in  the  minute  cells  of  the  investing  membrane 
of  the  whole  cellular  substance.  Should  such  a  patient  complain  of  being  ill, 
he  is  sure  to  be  laughed  at  for  his  pains — for  nobody  has  any  sympathy  with 
him — and  this  is  one  of  the  many  cases  in  the  world  where  "  appearances 
are  deceitful." 

The  dyspeptic  patient  is  either  torpid,  and  with  difficulty  roused  to  exer- 
tion, whether  corporeal  or  mental,  or  he  is  acted  upon  by  every  thing  he 
hears.  The  last  person  that  speaks  to  him  is  the  man  for  him.  His  spirits 
are  depressed  by  the  merest  trifle,  and  raised  again  by  a  straw  or  a  feather. 
Then,  as  regards  his  actions  or  his  promises,  you  can  scarcely  depend  upon 
anything  he  tells  you.  What  he  is  dying  to  do  to-day,  he  is  miserable  till  he 
can  again  undo  to-morrow  ;  he  spends  his  life  betwixt  acting  and  regretting; 
hesitating,  hoping,  and  fearing  by  turns — one  moment  all  confidence,  the  next 
all  suspicion.  Now,  is  not  this  one  of  the  strongest  of  many  striking  proofs 
how  much  our  mental  workings  are  the  effects  of  our  material  state  ;  the  re- 
Bult  of  our  brain's  condition,  and  its  atomic  relations  and  revolutions  ?  It  is  in 
•perfect  accordance  with  what  we  observe  in  all  our  corporeal  motions.  If  the 
muscles  be  tremulous,  can  you  wonder  that  the  mind  should  be  vacillating 
and  capricious  I  or  when  these  are  cramped  and  spasmodic,  why  should  you 
be  astonished  to  find  a  corresponding  wrong-headedness,  and  pertinacious, 
and  perverse  adherence  to  a  wrong  opinion  ? — mens  sana  in  corpore  sano. — 
You  may  argue  for  hours  to  no  purpose  whatever  with  some  patients ;  for 
how  can  you  expect  the  wrong  brains  of  wrong  bodies  to  reason  rightly  ? — 
These  persons  are  like  the  inebriated,  who  see  two  candles  when  there  is  only 
one ;  their  perceptions  being  false,  so  also  are  their  reasonings.  The  plunge 
bath,  or  a  short  course  of  chrono-thermal  treatment,  will  make  them  alter 
their  minds  sooner  than  the  most  powerful  and  persuasive  arguments  of  a 
Cicero  or  Demosthenes. 

Ladv  Mary  Montague  somewhere  says,  It  is  the  nature  of  the  world  to 
hate  truth.  She  came  to  this  opinion,  doubtless,  from  observing  how  badly 
the  public  had,  for  the  most  part,  treated  its  best  benefactors.  The  first  dis- 
covery of  anything  useful  generally  meets  with  the  fate  of  him  who  attempts 
to  open  the  eyes  of  a  person  imposed  upon — namely,  to  be  called  bad  names 
for  his  pains.  How  forcibly  this  reminds  us  of  the  jackass  that  kicked  the 
good-natured  man,  when  trying  to  relieve  the  stupid  brute  from  the  weight 
of  its  panniers ! 

The  pleasure  surely  is  as  great, 
Of  beiug  cheated  as  to  cheat. 

The  more  unscrupulous  and  unprincipled  the  impostor,  the  more  certainly 
he  has  appeared  to  fascinate  his  dupes.  Let  him  only  hold  out  an  impossi- 
bility to  them,  and  they  will  dance  attendance  at  his  door  for  months.  Tak- 
ing advantage  of  a  popular  but  puerile  prejudice  against  mineral  medicine,  the 
medical  charlatan  is  very  careful  to  prefix  the  word  vegetable  to  his  nostrum  ; 
and  this,  he  tells  the  public,  is  safe  in  every  form,  dose,  and  degree,  which 
being  in  utter  repugnance  to  every  other  thing  in  nature,  is  greedily  swallowed 
by  the  multitude,  as  an  indisputable  truth  !  Can  weight,  measure,  heat, 
cold,  motion,  rest,  be  so  applied  to  the  human  body  with  impunity?  Can 
you  without  injury  cover  yourselves  with  any  weight  of  clothes,  or  swallow 
any  measure  of  food  ?  Or  can  you  retain  any  part  of  the  body  in  perpetual 
motion  or  repose  without  that  part  suffering  ?  No,  truly  !  responds  the  same 
dyspeptic,  who  believes  that  such  and  such  a  medicine  is  safe  in  every  form, 


128  LECTURE  VI. 

dose,  and  degree  !  When  treating  patients  of  this  class,  it  is  better  not  to 
tell  them  what  they  are  taking  ;  but  should  they  chance  to  find  out  that  you 
have  been  giving  them  arsenic,  prussic  acid,  or  nitrate  of  silver,  you  will  be 
sure  to  be  worried  to  death  by  questions,  dictated  sometimes  by  their  own 
timidity,  and  sometimes  by  the  kind  feeling  of  some  "damned  good-natured 
friend,"  secretly  set  on  by  some  equally  damned  good-natured  apothecary. 
Now,  as  these  patients  are,  for  the  most  part,  great  sticklers  for  authority,  vour 
only  course  is  to  tell  the  truth — which,  after  all,  in  nine  cases  out  of  te^'will 
make  no  impression — and  that  is  the  reason  why  the  quack  and  subordinate 
practitioner,  who  can  keep  their  medicines  secret,  have  an  advantage  over  the 
honourable  physician — an  advantage  so  great,  that,  in  a  few  years,  if  matters 
do  not  take  a  turn,  I  doubt  if  one  such  will  be  found  practising  medicine  at  all. 
You  may  say  then  what,  if  it  have  no  effect  with  patients  themselves,  will 
at  least  appear  reasonable  to  their  friends — that  the  medicines  you  ordered 
are  all  contained  in  the  pharmacopeias  of  the  three  colleges  of  Edinburgh, 
London,  and  Dublin,  and  they  are  therefore  recognised  as  medicines  of  value 
by  all  the  physicians  who  have  a  name  to  make,  or  a  character  to  lose ;  that 
the  dose  in  which  you  give  them  is  perfectly  safe,  inasmuch  as,  if  it  disagree 
with  their  particular  constitutions,  it  will  only  cause  a  short  temporary  incon- 
venience ;  and  to  sum  up  all,  you  may  quote  Shakspeare,  who  says,  and 
says  truly,  "In  poison  there  is  physic."     And  again  : 

"  Oh  !  mickle  is  the  powerful  grace  that  lies 
In  herbs,  plants,  stones,  and  their  true  qualities : 
For  not  so  vile  that  on  the  earth  doth  live, 
But  to  the  earth  some  special  good  doth  give ; 
Nor  aught  so  good,  but,  strained  from  that  fair  use, 
Revolts  from  true  birth,  stumbling  on  abuse, 
Virtue  itself  turns  vice,  being  misapplied, 
And  vice  sometimes  by  actioii  dignified. 
Within  the  infant  rind  of  this  small  flower, 
Poison  hath  residence,  and  Medicine  power  !" 

So  that  physic  and  poison,  whether  vegetable  or  mineral,  are  physic  or  poison 
according  as  they  are  rightly  or  wrongly  applied. 

But  to  return  todyspepsia,  or  that  low  fever  so  termed.  In  cases  of  this  kind, 
my  practice  is  to  combine  the  chrono-thermal  remedies  with  what  you  may  call, 
if  you  please,  symptomatic  medicines.  For  example,  where  flatulence  is  the 
most  prominent  symptom,  I  prescribe  quinine,  hydrocyanic  acid,  or  nitrate 
of  silver,  with  aniseed  or  cardamons.  In  acidity,  either  of  the  two  first  re- 
medies will  often  answer  very  well  with  soda  or  potash.  Where  the  bowels 
are  slow  and  torpid,  rhubarb,  aloes,  or  both,  are  very  good  medicines  with 
which  to  combine  any  of  the  chrono-thermal  medicines.  In  such  cases  ape- 
rient effervescing  draughts  are  also  useful.  Should  the  patient  complain  of 
muscular  or  other  pains,  you  may  add  cplchicum  or  guaiac — and  so  pr 
in  a  similar  manner  with  other  symptomatic  remedies  for  other  local  indica- 
tions ;  keeping  in  mind,  however,  that  these  symptomatic  medicines  are 
merely  a  means  of  secondary  importance  in  the  treatment  of  a  great  constitu- 
tional totality  of  derangement.  In  addition  to  these  measures,  plasters  to  the 
back  or  stomach  may  be  very  beneficially  resorted  to  in  many  cas.  -  of 
dyspepsia,  and  you  may  also  run  the  changes  upon  various  kinds  of  baths. 
The  cold  plunge  and  the  shower  baths  are  my  favourites;  though  I  need  not 
tell  you  that  the  feelings  of  the  patient,  after  he  comes  out  of  it,  are  a  better 
guide  to  you  in  your  choice  and  continuation  of  any  bath  than  all  the  tin 
of  all  the  doctors  that  ever  wrote  or  reasoned  upon  disease  and  its  treatment. 
"  How  do  you  think  me  now,  doctor  ?"  is  a  question  I  am  asked  every  day, 
and  every  Jay  I  give  the  same  answer  :  "  How  do  you  feci  f"  If  the  patient 
he  will  be  sun:  to  tell  me  he  is  nol  bo  well ; 
and  according  to  his  answer  do  1  change  or  continue  bis  physio.  Now,  whe- 
ther this  be  common  sense  or  not,  I  leave  you  to  judge.     Heaven  only  knows 


LECTURE  VI.  129 

it  is  not  science,  or  what  very  learned  people  call  science  ;  for  when  the  pa- 
tient says  he  gets  worse  and  worse  every  day,  science  generally  tells  him  to 
continue  his  medicine,  for  that  he  has  not  taken  enough  of  it,  and  that  he  will 
be  worse  before  he  be  better — which  I  need  not  tell  you  is  a  lie — or  more 
politely  to  speak,  a  piece  of  imposture.  Should  the  patient  die,  why,  then, 
he  dies  a  natural  death,  and  he  has  had  the  first  advice,  for  not  only  did  Mr. 
So-and-so,  the  fashionable  apothecary,  attend  him,  but  Dr.  Such-a-one,  the 
great  physician,  who  also  called  in,  and  he  said  all  was  right,  and  that  noth- 
ing better  could  be  done.  Had  the  doctor  said  all  was  wrong,  he  might,  per- 
haps, have  been  nearer  the  mark ;  but,  in  that  case,  what  apothecary  would 
either  call  him  in  again  himself,  or  let  him  in  again,  when  requested,  where 
he  could  by  a  little  gentlemanly  trickery  keep  him  out  ?  In  my  own  parti- 
cular case,  the  custom  of  the  apothecary  has  been  secretly  to  play  upon  the 
fears  of  the  patient  or  his  friends  against  "  strong  medicine,"  to  shrug  his 
shoulders  and  smile  contemptuously.  "  Oh,  I  can  tell  you  something  of  Dr. 
Dickson,"  he  has  said,  "  but  you  must  not  give  up  me  as  the  author  ;"  where- 
upon he  has  proceeded  to  lie  Dr.  Dickson's  life  away;  and  when  he  had  thus, 
to  his  own  thinking,  sufficiently  poisoned  the  ear  of  his  patient,  he  has 
turned  round  in  this  manner  to  him — "  But  if  you  still  want  a  second  opinion, 
why  do,  you  not  call  in  Dr.  This,  or  Sir  Thingumy  T'other — they  are  lead- 
ing men,  you  know  !"  Now  that  only  means,  that  the  physicians  in  question 
are  the  fashionable  puppets  whom  he,  and  people  like  him,  call  in  to  conceal 
their  bad  work — men  who  would  as  soon  think  of  differing  with  the  opinion 
of  their  supposed  subordinates,  but  real  patrons,  as  of  quarrelling  with 
their  breakfast,  because  it  was  purchased  with  the  shilling  of  a  dead  man's 
guinea  ! 

"What  a  just  observation  was  that  of  the  author  of  Lacon  :  "  The  rich  pa- 
tient cures  the  poor  physician  much  more  often  than  the  poor  physician  the 
rich  patient ;  and  it  is  rather  paradoxical,  that  the  rapid  recovery  of  the  one 
usually  depends  upon  tbe  procrastinated  disorder  of  the  other.  Some  persons 
will  tell  you  with  an  air  of  the  miraculous,  that  they  recovered,  although  they 
were  given  over ;  when  they  might  with  more  reason  have  said,  they  re- 
covered^ because  they  were  given  over."  "  The  great  success  of  quacks  in 
England'  has  been  altogether  owing  to  the  real  quackery  of  the  regular 
physicians."  What  does  that  mean  ?  Just  this,  that  the  mortality  of  many 
legalised  practitioners,  even  of  the  highest  grade,  is  not  one  removed  above 
that  of  the  Morisons  and  St.  John  Longs,  whose  dishonest  practices  they  are  so 
constantly  decrying !  Now,  this,  you  will  say,  is  a  startling  statement — and 
much  will  doubtless  depend  upon  the  character  of  the  person  making  it, 
whether  you  treat  it  with  a  laugh  of  contempt,  or  listen  to  it  with  something 
like  respectful  attention.  Gentlemen,  the  man  who  deliberately  put  that  on 
paper  (and  I  quote  him  to  the  letter),  was  no  less  a  person  than  Adam  Smith, 
the  author  of  the  Wealth  of  Nations  !  If  such,  then,  was  the  certain  and 
settled  conviction  of  that  very  keen-sighted  observer  of  mankind,  will  any 
assertion,  any  asseveration  on  the  part  of  individuals  interested  in  declaring 
the  contrary,  weigh  with  you  one  straw  against  the  evidence  of  your  own 
senses,  when  you  choose  to  examine  this  matter  fairly  and  fully  for  your- 
selves ?  So  far  as  my  own  experience  goes — that  is,  from  what  I  have  seen 
of  the  profession  in  London  and  the  English  county  towns — eminence  in  medi- 
cine is  less  a  test  of  talent  and  integrity  than  a  just  reason  of  suspecting  the 
person  who  has  attained  to  it,  of  a  complete  contempt  for  both  !  I  say  sus- 
pecting— for  I  have  met  with  exceptions,  but  not  many,  to  the  rule.  Could 
you  only  see  as  I  have  seen,  the  farce  of  a  medical  consultation,  I  think  you 
would  agree  with  me,  that  the  impersonation  of  physic,  like  the  picture  of 
Garrick,  might  be  best  painted  with  comedy  on  one  side  and  tragedy  on  the 
other.  In  saying  this  much,  not  only  have  I  acted  against  everything  like 
medical  etiquette,  but  I  shall  be  sure  to  be  roundly  abused  by  the  medical 
profession  for  it.     The  truth,  however,  I  maintain  it  to  be,  but  not  the  whole 


130  LECTURE  VI. 

truth  !  for  the  world  must  have  its  eyes  a  little  more  open  before  it  can  be- 
lieve all  I  happen  to  know  upon  the  subject.  By-and-by  I  shall  tell  the 
English  people  something  will  make  their  ears  tingle ! 

To  return  to  the  consideration  of  disease.  You  now  see  that  in  all  cases 
of  which  we  have  been  speaking,  the  constitution  is,  for  the  most  part,  pri- 
marily at  fault,  and  that  the  names  of  disorders  depend  very  much  upon  the 
greater  or  less  prominence  of  some  particular  symptoms,  which  symptoms, 
or  their  shades,  may  be  readily  detected  in  all  diseases.  With  every  case 
of  dyspepsia,  depression  of  spirits,  and  more  or  less  mental  caprice,*  such  as 
hasty  or  erroneous  notions  upon  one  or  more  points,  will  be  found  to  be 
associated.  When  such  depression  amounts  to  despondency,  medical  men, 
according  to  the  sex  of  the  patient,  change  the  word  dyspepsia  into 

Hypochondria,  or  Hysteria; 

and  some  professors  are  very  particular  in  their  directions  how  to  distinguish 
the  one  from  the  other  !  Gentlemen,  what  is  the  meaning  of  Hysteria  ?  It 
is  a  corruption  of  the  Greek  word  vorsgn  (Hysteria,  the  womb  ;)  and  it  was 
a  name  given  by  the  ancients  to  the  particular  symptoms  we  are  now  consi- 
dering, from  a  hypothetical  idea  that  in  such  cases  the  womb  was  the  prin- 
cipal organ  at  fault.  From  the  same  language  we  also  derive  Hypochondria, 
a  compound  word  formed  of  vno  (Hypo,  under,)  and  %ov5$og  (Chondros,  car- 
tilage,) the  supposed  seat  of  the  disease  being  the  liver  or  stomach  ;  which 
organs  are  both  situated  under  the  cartilaginous  portions  of  the  lower  ribs. 
So  that  when  a  female  suffers  from  low  spirits  and  despondency,  with  occa- 
sional involuntary  fits  of  laughing,  crying,  sobbing,  or  shrieking,  you  must 
call  her  state  Hysteria;  and  when  a  male  is  similarly  affected,  you  must  say 
he  has  Hypochondria.  Now  it  so  happens,  medical  men  sometimes  pro- 
nounce even  their  male  patients  to  be  "  hysterical !"  And  this  brings  me  in 
mind  of  an  honest  Quaker  of  the  profession,  who,  being  very  ill,  had  three 
doctors  to  attend  him — Mr.  Abernethy,  Dr.  Blundell,  and  a  physician  whose 
name  I  now  forget.  Each  had  his  own  notion  of  the  disease  :  the  last  men- 
tioned, having  put  a  stethoscope  to  the  chest,  at  once  declared  the  '.'  Heart" 
to  be  the  seat  of  mischief.  Mr.  Abernethy,  on  the  contrary,  with  a  sarcastic 
"  pooh,  pooh  !"  muttered  something  about  the  "  stomach  and  digestive  or- 
gans,"— while  Dr.  Blundell,  in  the  true  spirit  of  a  man-midwife,  decided  that 
their  patient  was  only  "  hysterical."  Now  the  patient,  though  a  Quaker, 
was  a  humorist;  so  he  ordered  in  his  will,  that  when  his  body  should  be 
opened  after  his  death,  his  Digestive  Organs  should  be  presented  to  Mr. 
Abernethy,  his  Heart  to  his  stethoscope  physician,  and  to  Dr.  Blundell  his 
Womb,  if  he  could  find  one  ! 

Gentlemen,  that  the  Brain  is  the  principal  organ  implicated  in  all  disor- 
ders which  come  within  the  physician's  province,  more  especially  in  such  as 
are  termed  Hysteria  or  Hypochondria,  the  smallest  reflection  will  convince 
you.  Suppose  a  person  of  either  sex  has  been  accidentally  debilitated  by  loss 
of  blood — a  person  who  previously  was  strong  in  nerve  as  in  muscular  iibre  ; 
suppose  a  letter  comes  with  a  piece  of  bad  news — the  patient,  in  that  case, 
bursts  into  tears,  laughs  and  cries  time  about,  and  then  sinks  into  a  state  of 
dismal  and  gloomy  despondency.  And  all  this,  forsooth,  you  must  put  down 
to  the  state  of  the  womb  or  digestive  apparatus,  according  to  the  sex  of  the 
patient,  instead  of  placing  it  to  the  account  of  the  brain  and  nerves,  without 
which  the  ill-timed  letter,  the  cause  of  all,  could  not,  by  any  possibility,  have. 
affected  the  mind  in  the  least !  Another  class  of  practitioners,  scarcely  less 
unreasonable  than  those  to  whom  we  have  just  alluded,  will  have  it,  that 
patients,  coming  under  the  linul  of  hysteria  and  hypochondria,  nre  not  ill  at 
all. — "  Oh  !  there  is  nothing  the  matter  with  this  man,"  they  will  sny  ;  "  he 
is  only  hipped  !"  and  if  the  female,  "she  is  only  hysterical."  Dr.  RadclihY, 
when  he  refused  to  come  to  Queen  Anne,  declared  he  would  not  stir  a  foot. 


LECTURE   VI.  131 

"  for  there  was  nothing  the  matter  with  her  but  the  Vapours  !"  Such  was 
the  term  by  which  the  doctors  of  that  day  characterised  the  shifting  shades 
of  symptom  now  called  Hysteria.  Gentlemen,  do  I  require  to  tell  you  that 
no  man  or  woman  suffers  from  melancholy,  or  indulges  in  whims  and  phan- 
tasies, without  being  positively  ill  ?  Whoever  labours  under  mental  delusion 
or  despondency  has  alternate  chills  and  heats  ;  and  remissions  and  exacer- 
bations of  all  the  more  prominent  symptoms  characterise  the  disorder  in  eve- 
ry form.  The  late  Lord  Dudley,  in  a  letter  to  the  Bishop  of  Landaff,  re- 
lates his  own  case,  and  it  is  so  like  what  you  will  daily  meet  in  practice, 
that  I  shall  give  it  to  you  in  his  own  words  : — "  It  is  in  vain,"  he  says,  "  that 
my  reason  tells  me  that  the  view  I  take  of  any  unpleasant  circumstances  in 
my  situation  is  exaggerated.  Anxiety,  regret  for  the  past,  apprehensive  un- 
easiness as  to  my  future  life,  have  seized  upon  me  as  their  prey.  I  dread 
solitude ;  for  society  I  am  unfit ;  and  every  error  of  which  I  have  been  guilty 
in  life  stands  constantly  before  my  eyes.  I  am  ashamed  of  what  I  feel  when 
I  recollect  how  much  prosperity  I  still  enjoy ;  but  it  seems  as  if  I  had  been 
suddenly  transplanted  into  some  horrible  region  beyond  the  bounds  of  reason 
or  of  comfort :  now  and  then  I  enjoy  a  few  hours'  respite,  (the  remission  ?) 
but  this  is  my  general  condition.  It  is  a  dismal  contrast ;  for  you  will  re- 
member that  I  was  naturally  gay  and  cheerful."  Now,  although  Lord  Dud- 
ley recovered  perfectly  from  this  particular  attack,  his  disease,  at  a  later  pe- 
riod of  his  life,  returned  ;  but  this  time  he  was  less  fortunate  ;  for  the 
symptoms  of  his  disorder  gradually  deepened  in  their  hue,  until  they  amounted 
to  the  most  complete 

Insanity — 

a  proof  to  you  that  the  hypochondriac  whim,  and  the  hysteric  fancy,  differ 
from  hallucination  and  mania,  in  shade  merely,  and  the  chills  and  heats 
which  precede  .or  accompany  them,  from  the  cold  and  hot  stages  of  the  most 
intense  Fever,  in  nothing  but  degree.  Has  not  the  maniac,  in  every  form 
of  his  delusion,  lucid  intervals — remissions  ?  Your  schoolmen,  your  "  patho- 
logists," your  profound  medical  reasoners,  speak  of  madness  and  other  di- 
seases, as  if  they  were  the  effects  of  some  fixed  cerebral  malformation,  in- 
stead of  being  the  consequences  of  external  influences  acting  on  an  atomic 
instability  of  Brain.  They  tell  you  they  are  curable  or  not,  according  to  the 
Cause  ;  they  look  in  the  dead  body  for  the  causes  of  an  intermittent  living 
action — for  the  origin  of  hypochondria  and  mania — diseases  which  they  have 
even  themselves,  perhaps,  traced  to  hard  study  or  a  passion  !  External 
agencies,  then,  were  the  real  causes,  not  the  structural  deviations  detected 
within  after  death  by  the  scalpel.  Students  of  medicine  !  young  men  hon- 
ourably ardent  in  the  pursuit  of  knowledge,  for  the  sake  of  your  profession 
and  your  future  patients,  learn  to  think  for  yourselves.  Pause,  examine, 
weigh,  before  you  give  a  slavish  assent  to  the  dicta  of  your  teachers.  When 
these  tell  you,  that  madness,  with  a  lucid  interval,  is  an  inflammatory  es- 
sence, or  that  it  depends  upon  some  cerebral  malformation  or  tumour,  ask 
them  how  they  reconcile  days,  or  even  hours  of  sanity  and  sense  with  a  cer- 
ebral structure  thus  partially,  but  permanently  malformed  or  disorganised  ! 
That  medical  men,  mystified  from  boyhood  by  their  teachers,  should  fall  into 
such  errors,  is  not  so  astonishing  as  that  the  leaders  of  our  periodical  litera- 
ture should  be  equally  uufortunate.  What,  for  example,  can  be  more  egre- 
giously  absurd,  than  an  observation  the  reviewer  of  Lord  Dudley's  letters 
in  the  Quarterly  Review  has  allowed  to  escape  from  his  pen  !  "  The  gifts 
of  fortune  and  intellect,''''  says  this  writer,  "  were  counterbalanced  by  an  or- 
ganic malformation  of  the  brain."  How  can  intellectual  power  even  for 
one  moment  be  compatible  with  defective  cerebral  organization  ?  How  can 
the  cause  of  an  intermittent  disease  be  a  corporeal  entity,  or  something  per- 
manently fixed  ?  Let  no  sounding  words,  no  senseless  sophistry,  cheat  you 
of  a  reply  to  this  question.     The  maniac  who  has  lucid  intervals  is  curable 


132  LECTURE  VI. 

in  the  greater  number  of  instances — the  hypochondriac  who,  at  any  time  oi 
the  night  or  day,  enjoys  the  very  briefest  immunity  from  his  miserable  feel 
ings,  may  be  equally  susceptible  of  improvement  from  well-devised  remedia, 
means.  The  modern  medical  treatment  of  both  being  essentially  aggravant, 
can  you  wonder  that  these  diseases  should  so  often  remain  unrelieved,  or  that 
a  sceptic  smile  should  be  the  reward  of  the  individual  who  tells  you  that  in 
his  hands,  at  least,  they  have  ceased  to  be,  the  opprobria  of  medicine  ?  What 
has  been  the  result  of  the  antiphlogistic  treatment  of  insanity  ?  Let  the 
physicians  who  attended  Lord  Dudley  in  his  last  illness  answer  that  question, 
for  they  spared  neither  lancet  nor  leech  in  his  case.  In  the  case  of  Lord 
Byron,  "  delirium,"  which  is  only  another  word  for  mania,  was  actually  pro- 
duced by  the  lancet.  But  the  better  to  open  your  eyes  to  the  effect  of  such 
cruel  treatment  in  this  disease,  I  will  read  a  short  extract  from  a  letter  I  re- 
ceived from  Dr.  Hume,  the  same  staff-surgeon  whose  successful  practice  I 
have  already  had  occasion  to  detail  to  you. — "  I  lately,"  he  thus  writes, 
"  paid  a  visit  with  our  Depot  Paymaster  to  the  Armagh  lunatic  asylum. 
Being  the  receptacle  for  the  insane  poor  of  four  counties,  namely,  Monaghan, 
Fermanagh,  Cavan,  and  Armagh,  it  generally  contains  about  150  inmates 
Having  visited  the  different  apartments,  I  inquired  of  the  manager,  Mr. 
Jackson,  the  treatment  pursued.  His  answer  was  :  '  Although  I  am  not  a 
professional  man,  I  have  paid  great  attention  to  the  treatment  of  the  insane 
for  the  last  five-and-lwenty  years,  and  the  result  of  my  observation  is,  that 
the  usual  practice  of  bleeding,  leeching,  cupping,  &c,  only  aggravates  the 
condition  of  the  patients.  Of  those  who  were  bled  on  admission  I  never 
saw  one  recover.'  Now  this  is  a  curious  fact  elicited  from  a  plain,  practical 
man  of  great  experience,  who,  had  he  known  I  belonged  to  the  medical  pro- 
fession, might  not,  perhaps,  have  been  so  candid  in  his  remarks."  Dr.  Con- 
oily,  in  his  Report  of  the  Hanwell  Lunatic  Asylum,  is  obliged  to  admit  that 
great  numbers  die  shortly  after  their  admission  into  that  establishment.  The 
large  abstraction  of  blood  which  he  so  lauds  in  his  work  on  Insanity,  will 
easily  account  for  the  unsuccessful  termination  of  his  cases. 

Well,  then,  Gentlemen,  Hysteria,  Hypochondria,  Mania,  are  merely  mo- 
difications or  developements  of  chronic  or  habitual  low  Fever.  And  since 
I  commenced  to  treat  them  as  such,  I  have  had  a  practical  success  and  a 
mental  satisfaction,  that  contrast  somewhat  strongly  with  the  poor  opinion  I 
entertained  of  the  resources  of  our  art,  and  the  vexation  I  experienced  when 
first  entering  upon  my  professional  career.  This  much  you  should  know, 
however,  that  in  all  such  disorders  you  will  be  obliged  to  change  your  reme- 
dies frequently — for  in  chronic  diseases  what  will  often  succeed  to  admiration 
one  day,  may  as  often  have  an  opposite  effect  the  next ;  and  this  is  strictly 
in  accordance  with  what  you  find  in  every  thing  in  life.  The  tov  that  will 
stop  the  cry  of  the  weeping  child  to-day,  may  make  it  cry  more  loudly  to- 
morrow. You  must,  in  that  case,  change  its  rattle  for  some  other  gew-gaw  ; 
and  so  it  is  in  the  diseases  we  have  been  now  considering — diseases  where 
the  temperament  of  the  body,  like  the  temper  of  the  mind,  is  constantly  va- 
rying. The  great  secret  of  managing  chronic  diseases  properly,  consists  in 
the  frequent  change  and  right  adjustment  of  the  chrono-thermal  and  other 
remedies,  to  particular  cases  ;  and  this  also  explains  the  good  effect  of  Tra- 
velling upon  many  of  these  patients  ;  for  to  the  constantly  shifting  scenes 
and  to  the  frequent  repetition  of  novel  cerebral  excitement  produced  by  those 
scenes,  we  must  ascribe  the  chief  advantages  of  such  a  course  ; — clearly 
proving  that  the  Brain,  in  this  instance,  as  in  every  other,  is  the  true  key  to 
all  good  medical  treatment.  Whatever,  then,  be  the  name  by  which  vou 
choose  to  designate  your  patient's  complaint,  you  will  be  sure  to  meet  with 
nothing  but  disappointment,  if  you  pin  your  faith  exclusively  to  any  one  me- 
dicine. To-day  a  mild  emetic  will  give  reliff — temporary  only  if  vou  do 
not  follow  it  up  to-morrow,  with  iron,  opium,  musk,  quinine,  or  the  bath. 
One  week,  arsenic  will  be  a  divine  remedy  ;  the  next,  having  lost  its  power, 


LECTURE  VI.  133 

you  may  dismiss  it  for  prussic  acid,  valerian,  creosote,  strychnine,  or  silver. 
In  regard  to  silver,  the  nitrate  is  the  preparation  which  I  am  in  thr  habit  of 
using,  and  an  admirable  medicine  it  is,  when  properly  managed.  Boerhaave, 
the  greatest  physician  that  ever  lived,  speaks  most  highly  of  its  remedial 
powers  in  "nervous  complaints."  Cullen,  Pitcairn,  every  medical  man  but 
the  most  ill-educated  apothecary,  or  the  equally  ill-educated  puppet,  who 
enjoys,  at  the  mercy  of  his  breath,  the  reputation  of  being  par  excellence  a 
physician,  will  readily  bear  testimony  to  its  safety  and  value  as  a  medicine. 
Like  every  good  thing,  however,  the  nitrate  of  silver  has  been  abused  in 
practice,  and  in  some  half-dozen  instances  it  has  been  pushed  to  so  great  an 
extent  as  to  give  the  patient  a  permanent  blueness  of  skin  for  life.  But, 
Gentlemen,  in  these  cases,  the  practitioners  who  employed  it  committed  the 
double  error  of  giving  it  too  long  and  in  too  great  quantities ;  and  that  people 
should  entertain  a  prejudice  against  it  on  that  score,  is  just  as  reasonable  as  • 
that  a  man  should  be  afraid  to  warm  himself  when  cold,  because  his  next- 
door  neighbour  had  burnt  his  fingers  at  the  fire.  For  myself.  I  can  truly 
say,  that  though  I  have  prescribed  the  nitrate  of  silver  in  some  thousand 
cases  of  disease,  I  never  had  the  misfortune  to  give  the  slightest  tinge  to  the 
skin  of  a  single  individual.  But  should  objections  to  the  use  of  this  medicine 
still  continue  to  be  urged,  after  a  proper  explanation  on  your  part,  you  may 
be  pretty  sure  that  some  ignorant  or  interested  rival  has  been  secretly  play- 
ing upon  the  timidity  of  your  patient  or  his  friends.  In  that  case,  you  are 
less  to  be  pitied  than  the  patient ;  for  if  you  have  no  remedy  for  rascality, 
he  may  have  no  relief  for  his  suffering.  So  much,  then,  for  one  of  many 
annoyances  every  practitioner  must  experience  when  his  patient  happens 
to  be 

"  the  tool 

That  Knaves  do  work  with,  called  a  Fool." 

Bnt,  Gentlemen,  we  must  not  suppose  that  medicine  is  the  only  profession 
where  able  and  honourable  men  experience  such  annoyances.  Doctors  of 
divinity,  and  doctors  of  law,  are  equally  obnoxious  to  intrigue  and  prejudice  ; 
ay,  and  state-doctors,  too,  as  Sir  Robert  Peel  and  Lord  Melbourne  could  tell 
you,  if  you  would  ask  them. 

To  return.  The  shifting  shades  of  mental  distress,  and  the  various  vagaries 
and  wrong  thoughts — to  say  nothing  of  wrong  actions — of  persons  whose  dis- 
eases come  under  the  head  we  have  just  been  considering,  are  so  many  and 
so  multifarious,  that  to  attempt  to  describe  them  all  would  be  a  mere  waste 
of  time  and  labour  ;  inasmuch  as,  however  greatly  they  may  appear  to  differ 
from  each  other  in  shape  and  hue,  they  all  depend  upon  a  similar  totality 
of  corporeal  infirmity,  and  yield,  when  they  yield  at  all,  to  one  and  the  same 
system  of  corporeal  treatment.  A  few  instances  in  proof,  may  suffice  to  show 
you  this  : — 

Case  1 A  married  lady  consulted  me  under  the  following  circumstances  : 

Every  second  day,  about  the  same  hour,  she  had  an  unconquerable  wish  to 
kill  her  children,  and  when  she  happened  to  look  at  a  knife,  her  terror,  lest 
she  should  do  so,  was  extreme.  Now,  as  every  function  of  this  lady's  frame 
was  more  or  less  wrong,  I  prescribed  for  her  quinine  with  sulphuric  acid. — 
From  that  day,  she  had  no  return  of  the  homicidal  feeling. 

Case  2 A  gentleman,  every  second  day,  took  a  fit  of  suspicion  and  jeal- 
ousy of  his  wife,  without  the  slightest  cause  whatever,  as  he  confessed  to  me, 
on  the  day  of  remission,  when  he  called  to  consult  me ;  artd  however  absurd 
and  unreasonable  the  idea  which  haunted  him,  he  found  it  impossible  to 
drive  it  from  his  mind.  Prussic  acid  and  the  plunge  bath  cured  him 
completely. 

Case  3. — Another  gentleman,  after  a  hard  contest  at  his  university  for 
prize  honours,  suddenly  became  moody  and  sullen  ;  lost  his  flesh  and  appetite, 
and  fancied  himself  Judas  Iscariot.  Such  was  his  belief  one  day— to  be 
laughed  at  even  by  himself  the  next !     I  saw  him  six  times,  at  the  end  of 


134  LECTURE  VI. 

which  he  was  perfectly  cured  by  chrono-thermal  treatment.  Two  years 
afterwards,  his  sister  consulted  me  for  "  nervousness,"  when  I  learned  ihat 
ber  brother  had  not  had  the  slightest  symptom  of  return. 

Whoever  in  his  progress  through  life,  takes  the  trouble  to  study  individual 
character,  must  be  struck  by  the  perversities,  inconsistencies,  and  other  bizar- 
reries  of  the  human  mind.  Many  people,  for  example,  commit  follies,  faults, 
and  crimes  even,  involuntarily,  and  without  any  apparent  object.  Some  of 
you  may  possibly  remember  the  case  of  Moscati,  a  person  singularly  gifted 
with  talent,  but  who,  at  the  same  time,  had  such  an  invincible  disposition  to 
lie,  that  no  one  would  believe  him,  even  when  by  accident  he  spoke  the  truth. 
A  lady,  who  was  once  a  patient  of  mine,  told  me  that  every  time  she  became 
pregnant,  she  caught  herself  frequently  telling  lies,  for  no  end  or  purpose 
whatever.  I  knew  a  gentleman,  with  high  feelings  of  honour,  who  was  oc- 
casionally in  the  habit,  when  under  the  influence  of  wine,  of  pocketing  the 
silver  forks  and  spoons  within  his  reach  ;  you  can  easily  imagine  bis  distress 
of  mind  the  next  day,  when  he  packed  up  the  articles  to  return  them  to  their 
owners.  From  these  cases,  you  now  see  how  much  the  morale  of  every  one 
must  depend  upon  his  physique.  Attention  to  corporeal  temperature  will  be 
found  of  more  avail  in  mending  the  morals  of  some  individuals  than  a  well- 
written  homily. 

How  many  pretty  things  have  been  said  for  and  against  the  morality  of 
suicide  !  I  wish  it  were  always  in  a  person's  power  to  abstain  from  it.  But 
that  the  disposition  to  commit  it  may,  like  many  other  bad  dispositions,  be  cured 
by  medicine,  I  could  give  you  a  great  many  proofs.  However,  as  our  time 
will  not  now  permit  me  to  enter  into  these  subjects  so  fully  as  I  could  wish, 
I  shall  content  myself  with  reading  to  you  a  part  of  a  letter  I  some  time  ago 
received  from  Dr.  Selwyn,  formerly  "of  Ledbury,  now  of  Cheltenham. — 
Speaking  of  Mr.  Samuel  Averill,  of  the  Plough  Inn,  Dynock.  Gloucester- 
shire, Dr.  Selwyn  says  :  "  Before  he  came  to  me,  he  had  consulted  Mr. , 

of  Ledbury,  and  other  medical  men,  to  no  purpose,  as  you  can  easily  under- 
stand, when  I  tell  you  they  principally  went  over  the  old  routine  of  cupping, 
purging,  &c.  Mr.  Averill's  symptoms  were  depression  of  spirits  to  crying, 
thoughts  of  suicide,  fears  of  becoming  a  lunatic,  sleepless  nights,  and,  generally 
speaking,  the  greatest  possible  state  of  mental  wretchedness.  He  passed 
immense  quantities  of  urine,  as  pale  and  pellucid  as  water  from  the  pump. — 
Finding  no  particular  organ  in  a  worse  state  than  another,  I  thought  this  a 
good  case  for  your  doctrines :  and  accordingly  I  rang  the  changes  on  the 
jiitrate  of  silver,  strychnine,  musk,  prussic  acid,  creosote,  iron,  quinine,  and 
opium — varying  and  combining  these  according  to  circumstances  with  vale- 
rian, hartshorn,  blue  pill,  &c.  In  a  fortnight,  you  would  have  been  astonished 
at  the  improvement  effected  upon  him.  In  about  six  weeks  more,  he  had  nc 
complaint,  and  he  was  with  me  about  a  month  ago,  when  I  considered  his 
cure  complete.  I  have  treated  a  great  many  cases  of  dyspepsia  successfully, 
by  attending  to  the  intermittent  principle,  and  I  had  lately  a  case  of  tic  dou- 
loureux, which,  after  having  been  under  the  successive  treatment  of  several 
eminent  practitioners  with  no  perceptible  improvement,  yielded  to  the  chrono- 
thermal  remedies.     The  subject  of  it,  Miss  T -,  was  formerly  a  patient  of 

your  own  for  some  other  complaint.  I  still  hold  that,  in  chronic  diseases,  by 
keeping  your  principles  in  view,  we  have  a  great  help  in  many  of  those  ano- 
malous cases,  which  I  would  defy  a  nosologist  or  pathologist  to  name  or 
classify  ;  and  as  I  am  still  consulted  in  such  cases,  I  do  not,  I  assure  you, 
lose  sight  of  them.  Often,  indeed,  when  I  should,  under  the  scholastic  sys- 
tem, have  been  completely  puzzled  what  to  do,  I  now  proceed  at  once  to 
act  upon  the  intermittent  principle,  and  I  have  every  reason  to  be  satisfied 
with  my  success." 

Gentlemen,  that  the  numerous  diseases  which  medical  men  group  together 
under  the  head  of  dyspepsia,  hysteria,  and  hypochondria,  are  caused  by 
circumstances  from  without,  acting"  upon  an  atomic  instability  of  brain 


LECTURE  VI.  135 

might  be  proved  by  an  infinity  of  facts.  But  this  instability  may  be  pro- 
duced, or  put  in  action  rather,  by  different  influences  in  different  individuals 
— one  patient  being  only  susceptible  to  one  agent,  while  another  may  be 
acted  upon  literally  by  every  wind  that  blows.  The  late  General  O'Hara, 
for  example,  when  he  commanded  the  troops  on  the  Mediterranean,  waa  so 
sensible  of  the  Levant  wind,  that  before  he  rose  in  the  morning,  he  knew  if 
it  had  set  in,  by  the  effect  it  had  on  his  temper  ;  and  during  its  continuance, 
he  suffered  from  a  moroseness  and  irritability  no  effort  on  his  part  could  con- 
quer ;  by  his  own  desire,  his  servants  kept  out  of  his  way  on  these  occasions. 
The  different  effects  of  the  winds  on  the  human  system,  Shakspeare  well 
knew,  when  he  made  Hamlet  say, 


I  am  only  mad  north,  north-west, 


When  the  wind  is  southerly,  I  know  a  hawk  from  a  handsaw. 


And  in  confirmation  of  Shakspeare's  truthfulness  to  nature  on  this,  as  on  most 
other  occasions,  we  read  in  Sir  Woodbine  Parish's  Book  about  Buenos  Ayres, 
that  "  not  many  years  back,  a  man  named  Garcia,  was  executed  for  murder. 
He  was  a  person  of  some  education,  esteemed  by  those  who  knew  him,  and, 
in  general,  rather  remarkable  than  otherwise,  for  the  civility  and  amenity  of 
his  manners.  His  countenance  was  open  and  handsome,  and  his  disposition 
frank  and  generous  ;  but  when  the  north  wind  set  in,  he  appeared  to  lose  all 
command  of  himself;  and  such  was  his  extreme  irritability,  that  during  its 
continuance,  he  could  hardly  speak  to  any  one  in  the  street  without  quarrell- 
ing. In  a  conversation  with  my  informant,  a  few  hours  before  his  execution, 
he  admitted  that  it  was  the  third  murder  he  had  been  guilty  of,  besides  hav- 
ing been  engaged  in  more  than  twenty  fights  with  knives,  in  which  he  had 
both  given  and  received  many  serious  wounds  ;  but  he  observed  that  it  was 
the  north  wind,  and  not  he  that  shed  all  this  blood.  "When  he  rose  from  his 
bed  in  the  morning,  he  said  he  was  at  once  aware  of  its  accursed  influence 
upon  him ;  a  dull  headache  first,  and  then  a  feeling  of  impatience  at  every 
thing  about  him,  would  cause  him  to  take  umbrage,  even  at  the  members  of 
his  own  family,  on  the  most. trivial  occurrence.  If  he  went  abroad,  his  head- 
ache generally  became  worse,  a  heavy  weight  seemed  to  hang  over  his  tem- 
ples ;  he  saw  objects,  as  it  were,  through  a  cloud,  and  was  hardly  conscious 
where  he  went.  Such  was  the  account  the  wretched  man  gave  of  himself, 
and  it  was  corroborated  afterwards  by  his  relations,  who  added,  that  no  sooner 
had  the  cause  of  his  excitement  passed  away,  than  he  would  deplore  his 
weakness,  and  he  never  rested  till  he  had  sought  out,  and  made  his  peace 
with  those  whom  he  had  hurt  or  offended."  The  same  difference  of  effect 
upon  individuals  may  take  place  from  any  of  the  common  articles  of  diet. — 
Dr.  Millengen,  in  his  Curiosities  of  Medical  Experience,  tells  us  he  "  knew  a 
person  who  could  never  indulge  in  tea,  without  experiencing  a  disposition  to 
commit  suicide,  and  nothing  could  arouse  him  from  this  state  of  morbid  excite- 
ment but  the  pleasure  of  destroying  something — books,  papers,  or  anything 
within  his  reach.  Under  no  other  circumstance  than  this  influence  of  tea, 
were  these  fearful  aberrations  observed."  Coffee  affects  many  people  with 
fever.  But  if  coffee,  tea,  and  other  things  so  apparently  trifling  sometimes 
set  up  severe  disorder — things  equally  trifling  will  sometimes  cure  it— indeed 
there  is  nothing,  perhaps,  in  the  whole  history  of  disease  more  curious,  than 
the  readiness  with  which  the  paroxysm  of  many  complaints  will  occasionally 
yield  to  measures  so  simple,  and  so  seemingly  powerless  in  themselves,  it 
might  almost  seem  puerile  to  suggest  their  application.  Who,  for  example, 
could,  a  priori,  suppose  it  possible  to  stop  a  fit  of  mania  with  a  thread  ?  or 
who  would  be  believed,  were  they  to  tell  a  person  that  had  never  heard  the 
like  before,  that  aches  and  agues  had  been  cured  with  a  song  ?  Yet  in  sober 
truth,  such  things  have  been  actually  done  ! 


136  LECTURE  VI 


Effect  of  Ligatures. 


Of  the  power  of  mere  words  over  the  morbid  motions  of  the  body,  we  shall 
afterwards  have  occasion  to  speak.  Of  the  efficacy  of  a  thread  or  ribbon 
in  arresting  the  maniacal  paroxysm,  I  shall  now  give  yon  a  striking  example, 
from  the  Annales  dy  Hygiene  Publique,  et  de  Medecine  Legale.  "  Mr. 
R .  a  chemist,  naturally  of  gentle  disposition,  voluntarily  claimed  admis- 
sion to  a  madhouse  in  the  Faubourg  St.  Antoine,  on  account  of  a  desire  to 
commit  homicide,  with  which  he  was  tormented.  He  threw  himself  at  the 
foot  of  the  altar,  and  supplicated  the  Almighty  to  deliver  him  from  the  horrible 
propensity.  Of  the  origin  of  his  disease,  he  could  say  nothing ;  but  when  he 
felt  the  accession  of  the  fatal  desire,  he  was  in  the  habit  of  running  to  the  chief 
of  the  establishment,  and  requesting  to  have  his  thumbs  tied  together  with  a 

ribbon.     However  slight  the  ligature,  it  sufficed  to  calm  the  unhappy  R ; 

though  in  the  end,  he  made  a  desperate  attempt  upon  one  of  his  keepers,  and 
perished  at  last  in  a  paroxysm  of  fury."  Now,  every  man  of  any  informa- 
tion in  the  profession,  knows  that  the  application  of  a  ligature  to  the  arm  or 
leg  will  frequently  stop  the  commencing  ague-fit.  Dr.  Davis,  in  his  account 
of  the  Walcheren  ague,  tells  us  he  very  often  arrested  it  merely  by  grasping 
the  leg  or  arm  strongly  with  his  hand.  Putting  aside,  then,  all  consideration 
of  theintermittent  nature  of  the  case  of  homicidal  mania  I  have  just  read — 
all  consideration  of  the  thermal  and  other  changes  which  usher  in  the  fit  of 
every  maniacal  case,  you  could  not  fail  to  find  in  the  very  simple  measure, 
which  may  equally  succeed  in  preventing  or  arresting  the  fit  of  mania  and 
ague,  a  new  bond  of  connexion  with  which  to  associate  ague  and  mania  to- 
gether in  the  same  category.  But,  Gentlemen,  these  are  not  the  only  com- 
plaints in  which  the  ligature  may  be  thus  advantageously  employed.  In 
epilepsy,  asthma,  and  other  convulsive  affections,  I  have  often  obtained  the 
same  salutary  result  by  its  application.  Not  very  long  ago,  I  happened  to 
be  in  the  room  of  a  medical  man,  when  he  was  unexpectedly  seized  with 
cramp  in  his  back  and  loins.  Observing  him  to  become  pale  and  shiver  all 
over,  I  caught  him  suddenly  by  the  arm  and  opposite  leg.  "  My  God  !"  he 
exclaimed,  "  I  am  relieved."  And  his  astonishment  was  extreme ;  for  im- 
mediately afterwards  he  became  warm  and  comfortable ;  though  for  several  days 
previously,  he  had  been  suffering  from  cold  feet  and  general  malaise.  Mania, 
epilepsy,  asthma,  cramp,  ague,  then,  completely  establishing  their  relation- 
ship by  means  of  the  ligature  ;  for  had  we  no  other  facts,  no  other  bond  of  as- 
sociation than  that  which  the  ligature  furnishes  us,  we  would  still  be  led  to 
the  irresistible  conclusion,  that  those  particular  diseases,  at  least,  amid  all  their 
apparent  diversity,  have  yet  some  principle  in  common  which  determines 
their  unity.  When  I  come  to  explain  to  you  the  manner  in  which  the  liga-  ' 
ture  acts,  you  will  find  that  the  connecting  link  of  the  whole  is  the  brain. — 
Thev  are  all  the  result  of  a  weak  and  exhausted  state  of  that  organ;  but  not, 
as  the  late  Dr.  Mackintosh,  of  Edinburgh,  supposed,  produced  by  any  conges- 
tion or  fulness  of  its  blood-vessels.  This,  you  know,  was  his  doctrine  of  the 
Cause  of  Ague  ;  and  as  he  was  a  very  eloquent  man,  and  a  very  pleasant 
and  gentleman-like  person  to  boot,  he  made  many  proselytes  to  his  opinion* 
not  only  among  his  own  pupils,  who  were  very  numerous,  but  also  among 
the  profession  generally,  To  prove  his  hypothesis,  or  dream  rather,  he  was 
in  the  habit,  first  of  detailing  the  "congestion"  found  on  dissection  of  the 
heads  of  persons  who  had  died  in  the' cold  stage  of  ague, — and  then  he  ap- 
pealed to  the  relief  which  very  often  followed  the  practice  of  bleeding  at  the 
commencement  of  that  stage.  "  Behold  the  fact,"  he  would  say;  "behold 
how  the  shiverings  cease  the  very  moment  you  open  the  vein — what  can  be 
a  more  triumphant  answer  to  the  opponents  of  the  lancet !"  But  mark  the 
fallacy  of  that  fact — mark  how  the  too-confident  doctor  was  deceived  by  his 
own  practice.  The  relief  of  which  he  boasted — for  the  most  part  temporary 
only,— instead  of  being  produced  by  the  very  trilling  quantity  of  blood  which 


LECTURE   VI.  137 

flowed  before  such  relief  was  obtained,  was  in  reality  nothing  more  than  the 
effect  of  the  ligature  by  which  the  arm  was  necessarily  bandaged  for  the 
operation  !  The  late  Dr.  Parr  tells  us,  that  when  called  to  a  patient  in  the 
fit  of  Asthma,  he  was  in  the  habit  of  tying  up  the  arm  as  if  he  intended  to 
bleed,  but  that,  though  he  never  did  more  than  scratch  the  skin  with  his 
lancet,  the  fit  was  at  once  arrested.  But,  Gentlemen,  Ague,  Asthma,  Epi- 
lepsy,— nay,  every  one  of  the  non-contagious  diseases  to  which  man  is  liable, 
have  all  been  produced  by  loss  of  blood.  In  that  case,  at  least,  they  must 
have  been  diseases  of  exhaustion, — the  effects,  in  a  word,  of  diminished  cere- 
bral power.  But  when  we  come  to  consider  that,  in  every  instance  in  which 
the  causes  of  the  diseases  now  under  consideration  have  been  known,  the 
Brain  has  been  suddenly  and  primarily  affected — as  in  the  case  of  a  blow,  a 
poison,  a  purge,  a  passion,  we  can  be  at  no  loss  in  forming  an  opinion  as  to 
the  real  nature  of  these  diseases  ; — they  are  all  the  effect  of  cerebral  weak- 
ness, and  have  all  more  or  less  analogy  to  faint.  Faint,  in  fact,  may  be 
the  premonitory  symptom  of  them  all ;  and  the  Walcheren  ague  in  particular, 
generally  began  with  a  fainting  fit, — which  faint  was  sometimes  so  alarming 
as  to  cause  the  greatest  possible  anxiety  in  the  minds  of  the  attendants  for 
the  immediate  result.     Now,  what  is  the  condition  of  the  body  you  call 

Faint  1 

Is  it  not  a  state  very  like  death  ?  A  person,  from  his  brain  all  at  once 
ceasing  to  act,  becomes  instantly  pale  and  pulseless, — the  blood,  having  thus 
suddenly  left  the  arteries  and  ez-ternal  vessels  of  the  body,  must  go  some- 
where else.  Had  we  never  dissected  a  person  who  had  died  of  faint,  we 
should  naturally  expect  it  to  settle  in  the  m-ternal  veins  ;  and  there  accord- 
ingly, when  we  do  dissect  the  bodies  of  such  persons,  we  do  find  the  greater 
part  of  the  blood.  Now,  this  was  what  first  misled  Dr.  Mackintosh.  On 
opening  the  heads  of  subjects  who  had  died  in  the  cold  fit  of  ague,  he  almost 
invariably  found  the  veins  of  the  Brain  gorged  with  Blood.  This  constant 
Effect  of  every  kind  of  exhaustion  he  at  once  presumed  was  the  Cause  of  such 
exhaustion.  Gentlemen,  he  did  not  know  that  the  very  same  internal  vascu- 
lar fulness  may  be  seen  on  opening  the  bodies  of  those  who  die  of  loss  of 
blood  !     To  prove,  however,  what  I  say, — to  demonstrate  to'  you  that  this 

Congestion, — 

this  bugbear  of  medical  quidnuncs,  instead  of  being  the  invariable  Cause,  is 
in  reality  the  invariable  Effect,  of  sudden  exhaustion,  I  shall  now  read  to  you, 
one  of  several  experiments  in  which  Dr.  Seeds  bled  healthy  dogs  to  death. 
The  editor  of  the  Medical  Gazette  will  pardon  me  for  reading  it  from  his 
pages  ;  but  as  my  facts  have  been  sometimes  said  to  be  "  selected  facts,"  I 
have  at  least  this  answer  in  store,  that,  in  the  great  number  of  instances, 
they  have  been  selected  from  the  writings  of  my  opponents. 

"  All  the  larger  veins  of  the  legs,"  Dr.  Seeds  tells  us,  "  were  opened  in  a 
small  dog.  At  first  the  pulse  was  accelerated,  soon  after  it  became  slow  and 
languid.  °  The  heart's  motions,  though  feeble,  were  never  irregular  ;  and,  in- 
deed, long  before  death,  they  could  neither  be  seen  nor  felt.  Borborygmi 
[flatulent  gurglings]  were  early  heard,  and  lasted  a  long_  time.  The 
breathing  at  first  was  hurried ;  soon  it  became  slow  and  laborious ;  and  at 
last  convulsive.  The  pupils  were  frequently  examined  :  they  became  gradu- 
ally less  and  less  obedient  to  the  influence  of  light,  and  at  length  ceased  to 
contract  altogether.  [That  is,  they  became  dilated.]  Slight  spasmodic 
contractions  took  place,  first  in  the  femoral  and  abdominal  muscles  ;  then  the 
head,  neck,  and  fore-legs,  were  likewise  powerfully  affected  with  spasms,  [or 
convulsions.]  At  this  time  a  deep  sleep  seized  the  animal :  he  breathed  slowly, 
and  with  difficulty,  and,  for  a  little  time  before  death,  respiration  at  intervals 
was  suspended  altogether.     [All  the  symptoms  of  apoplexy  !]    Whenever  the 


138  LECTURE  VI. 

breathing  was  strong  and  quick,  the  pupils  recovered  their  tone,  and  the 
blood  was  more  strongly  propelled.  In  an  hour  death  closed  the  scene." 
Now,  Gentleman,  for  the  dissection  :  "  The  Dissection  of  the  Head  was 
first  begun.  The  membranes  of  the  Brain  were  loaded  with  turgid  vessels, 
the  larger  of  which  were  of  a  very  dark  colour.  A  bright  red  spot  was  ob- 
served near  the  cornua,  where  some  degree  of  sanguineous  effusion  had  taken 
place.  The  sinuses  were  full  of  blood.  In  all  the  ventricles  there  was 
more  or  less  water  effused  :  the  base  of  the  brain,  and  the  eighth  and  ninth 
pairs  of  nerves,  were  inundated  with  water.  A  net-work  of  red  vessels  was 
spread  round  their  origins,  and  the  optics  were  in  the  same  state.  In  the 
cervical  and  lumbar  regions  of  the  spinal  marrow  there  was  a  considerable 
degree  of  redness.  The  right  side  of  the  Heart  was  full  of  blood;  the  left 
auricle  contained  a  little.  Some  blood  was  found  in  the  large  veins,  and  a 
few  clots  in  the  thoracic  aorta.  The  stomach,  and  all  the  intestines,  were 
tumid  with  flatus ;  the  veins  of  the  mesentery  were  turgid.  The  turgid 
state  of  the  veins  of  the  head  was  very  remarkable:  indeed,  through- 
out THE  WHOLE  BODT    THE  VEINS  WERE  TUMID." 

Now,  Gentlemen,  if  anything  in  this  world  could  open  the  eyes  of  "  patho- 
logical "  professors, — if  facts  or  reasoning  of  any  kind  could  possibly  move 
those  mechanical-minded  persons,  who  plan  their  treatment  of  living  men  from 
what  they  see  on  dissecting  dead  bodies, — this  and  similar  experiments  ought 
surely  to  do  so.  For  here  you  not  only  find  dilated  pupil,  convulsions,  deep 
sleep,  slow  and  difficult  breathing,  with  other  apoplectic  symptoms,  the 
effect  of  literally  bleeding  a  healthy  animal  to  death ;  but,  to  complete  the 
deception  of  such  as  constantly  ascribe  these  phenomena  to  pressure  on  the 
Brain,  the  cerebral  and  other  veins  of  the  same  animal  were  found  after  death 
loaded  and  congested  with  blood  throughout !  Nay,  in  addition  there  was 
water  on  the  Brain,  with  "  some  degree  of  sanguineous  effusion  "  even.  Gentle- 
men, you  constantly  hear  of  children  dying  of  "  water  on  the  Brain."  I 
scruple  not  to  declare,  that  in  ninety-nine  of  every  hundred  such  cases,  the 
water  in  the  Brain  is  produced  by  the  lancet  or  leeches  of  the  doctor  ! 

Not  long  ago,  I  was  shocked  with  the  details  of  an  Inquest  which  took 
place  before  the  coroner  for  Middlesex,  Mr.  Wakeley,  who  is  also  the  editor 
of  the  Lancet.  The  Inquest,  according  to  the  report  in  that  paper,  was  held 
on  the  body  of  a  man,  who,  in  the  act  of  disputing  with  his  master  about  his 
wages,  "  turned  suddenly  pale,  and  fell  speechless  and  insensible  fur  a  time, 
breathing  heavily  until  his  neckerchief  was  loosed.  In  falling,  his  head  struck 
the  edge  of  a  door  and  received  a  deep  wound  three  inches  long,  from  which 
blood  flowed  enough  to  soak  through  a  thick  mat  on  the  floor."  Before  being 
taken  from  his  master's  shop  to  his  own  house,  he  recovered  sufficiently  to 
complain  of  pain  of  his  head  ;  and  this  fact  I  beg  you  will  particularly  mark. 
"  His  wife  immediately  sent  for  a  doctor ;"  and  what  do  you  think  was  the 
first  thing  the  doctor  did, — what  can  you  possibly  imagine  was  the  treatment 
which  this  wise  man  of  Gotham  put  in  practice  the  moment  he  was  called  to 
a  person  who  had  fallen  down  in  a  FAINT,  and  who,  from  the  injury  occa- 
sioned by  the  fall,  had  lost  blood  "enough  to  soak  through  a  thick  matl" 
"Why,  to  bleed  him  again !  And  what  do  you  think  was  the  quantity  of 
blood  he  took  from  him?  More  than  Three  pints  !  The  landlady  of  the 
house,  and  she  was  corroborated  by  other  witnesses,  swore  that  "  Bhe  thought 
that  about  Three  and  a  fifth  pints  of  blood  were  taken  besides  what  was  spik 
on  the  floor.  The  bleeding,  she  calculated,  occupied  twenty  minutes.  The 
bandage  also  got  loose  in  bed,  and  some  blood,  not  much,  was  lost  tiiere  before 
its  escape  was  discovered.  He  had  convulsions  on  Saturday,  after  which 
he  lay  nearly  still,  occasionally  moving  his  head.  On  Sunday  he  was  more 
exhausted  and  quiet;  in  the  evening  he  was  still  feebler,  and  on  Monday 
afternoon,  at  ten  minutes  to  one,  without  having  once  recovered  his  sensibility 
to  surrounding  objects,  he  died."  Remember,  Gentlemen,  he  did  recovtl 
his  sensibility  after  he  left  his  master's  shop, — lie  even  complained  of  head- 


LECTURE  VI.  139 

ache ;  but  after  having  been  bled  by  the  doctor  he  relapsed  into  his  former 
state  of  unconsciousness.  How  could  he  possibly  survive  such  repeated  loss 
.of  blood  ?  That  he  died  from  such  loss  of  blood  was  the  opinion  of  every 
person  who  heard  the  evidence,  till  Mr.  Wakley,  the  Coroner,  luckily  for 
"  the  doctor,"  had  the  corpse  opened.  Then,  sure  enough,  just  as  in  the  case 
of  the  dog  that  was  bled  to  death,  the  internal  veins  were  found  to  be  turnd 
and  congested  throughout.  Deceived  by  this  very  constant  result  of  any 
great  and  sudden  loss  of  blood,  Mr.  Wakely  and  the  jury  were  now  convinced, 
not  that  the  man  had  been  bled  to  death,  but  that  he  had  not  been  bled 
enough  !  One  of  the  strongest  proofs  of  bad  treatment  was  thus  received  as 
evidence  of  the  best  possible  treatment  under  the  circumstances — and  a  ver- 
dict pronounced  accordingly  !  That  an  ignorant  coroner  and  an  ignorant  jury 
should  be  imposed  upon  in  this  manner,  is  nothing  very  wonderful ;  but  that  the 
Editor  of  the  Lancet,  who  publishes  the  case,  and  who,  from  his  position, 
knows  every  thing  going  on  at  the  present  time  in  the  medical  world,  should 
in  his  capacity  of  coroner  pass  over,  without  a  word  of  reprobation,  a  mode 
of  practice  no  conceivable  circumstances  could  justify,  only  shows  the  lamen- 
table state  of  darkness  in  which  the  profession  are  at  this  very  moment  on 
every  thing  connected  with  the  proper  treatment  of  disease  !  When  St.  John 
Long,  or  any  other  unlicensed  quack,  by  an  overdose,  or  awkward  use  of 
some  of  our  common  remedies,  chances  to  kill  only  one  out  of  some  hundreds 
of  his  dupes,  he  is  immediately  hunted  to  death  by  the  whole  faculty  ;  but 
when  a  member  of  the  profession  at  one  bleeding  takes  more  blood  by  three 
times  than  is  taken  on  any  occasion  by  practitioners  who  kill  their  man  every 
day  with  the  lancet, — not  from  a  strong,  powerful  man,  but  from  a  person  so 
weakly  that  during  the  excitement  of  a  trifling  dispute  with  his  master,  he 
fainted  and  fell,  and  in  falling  had  already  lost  blood  enough  to  soak  through 
a  thick  mat, — not  a  word  of  blame  is  said  !  On  the  contrary,  it  was  all  right ; 
or  if  there  was  any  error,  it  was  on  the  safe  side  !  If  such  things  be  permitted 
to  be.done  in  the  heart  of  the  metropolis,  not  only  without  censure,  but  with 
something  like  praise  even,  homicide  may  henceforth  cease  to  be  looked  Upon 
as  a  reproachable  act.  The  only  thing  required  of  the  perpetrator  is,  that  he 
should  do  it  uncter  the  sanction  of  a  diploma,  and  secundum  artem  ! 

But,  Gentlemen,  to  return  to  Ague,  and  the  other  morbid  motions  which 
led  to  this  digression,  Some  of  you  may  be  curious  to  know  how  so  simple 
a  thing  as  the  Ligature  can  produce  such  a  salutary  effect  in  these  disorders. 
I  will  tell  you  how  it  does  this — and  the  explanation  I  offer,  if  received  as 
just,  will  afford  you  an  additional  proof,  not  only  that  these  diseases  have  all 
their  common  origin  in  the  Brain,  but  that  they  are  all  the  natural  conse- 
quences of  an  arrest  or  other  irregularity  of  the  atomic  movements  of  the 
different  portions  of  that  organ  ;  for  to  the  diversity  of  the  cerebral  parts,  and 
the  diversity  of  the  parts  of  the  body  which  they  respectively  influence,  we 
ascribe  the  apparent  difference  of  these  diseases,  according  to  the  particular* 
portion  of  the  brain  that  shall  be  most  affected  by  some  outward  agency. 
Thus,  after  a  blow  on  the  head,  or  elbow  even,-  one  man  shall  become  sick, 
and  vomit ;  another  fall  into  convulsions  ;  a  third  shiver,  fever,  grow  deliri- 
ous, and  become  mentally  insane.  In  all  these  diseases,  the  atomic  move- 
ments of  the  Brain  being  no  longer  in  healthy  and  harmonious  action,  the 
natural  control  which  it  exercised  in  health  over  every  part  of  the  body, 
must  be  then  more  or  less  withdrawn  from  the  various  nerves  through  which 
it  influenced  the  entire  economy.  '  The  consequence  of  all  this  is,  that  some 
organs  are  at  once  placed  in  a  state  of  torpidity,  while  others  act  in  a  manner 
alike  destructive  to  themselves,  and  the  other  parts  of  the  body  with  which 
they  are  most  nearly  associated  in  function.  We  find  palsy  of  one  organ, 
and  spasm  or  palpitation  of  another.  In  fact,  if  I  may.  be  permitted  to  use 
so  bold  a  simile,  the  various  organs  of  the  body,  when  beyond  the  control  of 
the  Brain,  resemble  so  many  race-horses  that  have  escaped  from  the  control 
of  their  riders — one  stands  still  altogether ;   another  moves  forward  in  the 


140  LECTURE  VI. 

right  course  perhaps,  but  with  vacillating  and  uncertain  step ;  while  a  third 
endangers  itself  and  every  thing  near  it,  by  the  rapidity  or  eccentricity  of  ita 
movements.  When  the  atoms  of  the  various  parts  of  the  Brain,  on  the  con- 
trary, act  in  harmony  with  each  other,  there  is  an  equally  harmonious  action 
of  every  organ  of  the  body — supposing,  of  course,  every  organ  to  be  perfect  in  its 
construction.  "Whatever  suddenly  arrests  or  puts  into  irregular  motion  the 
whole  cerebral  actions,  must  with  equal  celerity  influence  the  previous  motive 
condition  of  every  member  and  matter  of  the  body — for  evil  in  one  case,  for 
good  in  another.  Were  you  suddenly  and  without  any  explanation  to  put  a 
ligature  round  the  arm  of  a  healthy  person,  you  would  to  a  dead  certainty 
excite  his  Alarm  or  Surprise.  Now,  as  both  of  these  are  the  effects  of  novel 
cerebral  movements,  would  you  not  thereby  influence  in  a  novel  manner  every 
part  of  his  economy  ?  How  should  you  expect  to  influence  it  ?  Would  not 
most  men  in  these  circumstances,  tremble  or  show  some  kind  of  muscular 
agitation  ? — their  hearts  would  probably  palpitate — they  would  change  colour, 
becoming  pale  and  red  by  turns,  according  as  the  Brain  alternately  lost  and 
recovered  its  controlling  power  over  the  vascular  apparatus.  If  the  alarm 
was  very  great,  the  pallor  and  tremor  would  be  proportionally  long.  But  in 
the  case  of  a  person  already  trembling  and  pale  from  another  cause,  the  very 
natural  effect  of  suddenly  tying  a  ligature  round  the  arm  would  be  a  reverse 
effect — for  if  the  cerebral  motive  condition  should  be  thereby  changed  at  all, 
it  could  only  be  by  a  reverse  movement ;  and  such  reverse  cerebral  move- 
ment would  have  the  effect  of  reversing  every  previously  existing  movement 
of  the  body.  The  face  that  before  was  pale,  would  now  become  redder  and 
more  life-like  ;  the  trembling  and  spasmodic  muscles  would  recover  their 
tone  ;  the  heart's  palpitation  would  become  subdued  into  healthy  beats  ;  and 
a  corresponding  improvement  would  take  place  in  every  other  organ  and 
function  of  the  body. 

The  ligature,  then,  when  its  application  is  successful,  acts  like  every  other 
remedial  agency  ;  and  a  proper  knowledge  of  its  mode  of  action  affbrds  us 
an  excellent  clue  to  the  mode  of  action  of  medicinal  substances  generally  ;  all 
of  which,  as  you  have  already  seen,  and  I  shall  still  further  show,  are,  like 
the  ligature,  capable  of  producing  and  curing  the  various  morbid  motions  for 
which  we  respectively  direct  their  administration.  It  is  in  this  manner  that 
every  one  of  the  various  passions  may  cause  or  cure  every  disease  you  can 
name;  always  excepting,  as  I  have  said  before,  the  properly  contagious  dis- 
orders. The  brain,  Gentlemen,  is  the  principal  organ  to  which,  in  most  cases, 
you  should  direct  your  remedial  means.  ■  When  a  person  faints  and  falls, 
whatever  be  the  cause  of  such  faint — a  blow,  a  purge,  or  loss  of  blood — the 
first  thing  to  be  done  is,  to  rouse  the  brain.  You  must  throw  cold  water  on 
his  face,  put  hartshorn,  snuff,  or  burnt  feathers  to  his  nose  ;  and  a  little  brandy, 
if  you  can  get  it,  into  his  mouth.  You  may  also  slap  or  shake  him  strongly 
with  your  hand  ;  if  you  can  only  make  him  feel,  you  will  be  almost  sure  to 
recal  him  to  life :  but  to  think  of  bleeding  a  person  in  such  a  state — ha  !  ha  ! 
After  all,  this  is  no  laughing  matter  ;  for  when  we  see  such  things  done  in  the 
nineteenth  century,  we  should  rather  blush  for  a  profession  that  would  en- 
deavour to  screen  any  of  its  members  from  the  contempt  they  merit,  when 
they  have  so  far  outraged  everything  like  decency  anil  common  sense.  The 
proper  treatment  of  a  fit  of  fainting  or  convulsion,  should  be  in  principle  the 
same  as  you  may  have  seen  practised  by  any  well-informed  midwife,  in  the 
case  of  children  that  are  still-born — children  all  but  dead.  You  may  have 
seen  the  good  lady  place  the  child  on  her  knee,  and  beat  it  smartly  iind  re- 
peatedly with  her  open  hand  on  the  hips  and  shoulders,  or  suddenly  plunge 
it  into  eold  water  ;  now  while  this  is  doing,  the  infant  will  often  give  a  gasp 
or  two,  and  then  cry  ;  that  is  all  the  midwife  wants.  And  if  you  will  only 
follow  her  example  in  the  case  of 

Infantile  Convulsions, 
which,  alter  all,  are  the  very  same  thing  as  epileptic  fits  in  the  adult — you 


LECTURE  VI  141 

will  often  succeed  in  substituting  a  fit  of  crying — which,  I  need  hardly  say, 
is  attended  with  no  danger  at  all — for  a  spasmodic  fit,  which,  under  the  rou- 
tine treatment,  is  never  free  from  it.  Only  get  the  child  to  cry,  and  you  need 
not  trouble  yourself  more  about  it ;  for  no  human  creature  can  possibly  weep 
and  have  a  convulsive  fit  of  the  epileptic  or  fainting  kind  at  the  same  moment. 
Convulsive  sobbing  is  a  phenomenon  perfectly  incompatible  with  these  move- 
ments ;  for  it  depends  upon  a  reverse  action  in  the  atoms  of  the  brain.  The 
only  thing  which  may  prevent  some  of  you  from  doing  your  duty  on  such 
occasions,  is  the  fear  of  offending  an  ignorant  nurse  or  mother,  who  will  think 
you  a  monster  of  cruelty  for  treating  an  infant  so.  Gentlemen,  these  persons 
do  not  know  how  difficult  it  is  to  get  a  child  in  convulsions  to  feel  at  all ;  and 
in  proof  of  this,  I  may  tell  you,  that  such  slaps  as  in  a  perfectly  healthy  child 
would  be  followed  by  marks  that  should  last  a  week,  in  cases  of  this  descrip- 
tion leave  no  mark  whatever  after  the  paroxysm  has  ceased.  During  the  fit, 
the  child  is  so  perfectly  insensible  as  to  be  literally  all  but  half-dead. 

What  is  the  present  routine  treatment  of  an  infant  taken  with  convulsive 
fits  ?  That  I  can  scarcely  tell  you ;  but  when  I  settled  in  London,  some  six 
years  ago,  the  court  doctors,  who,  of  course,  gave  the  tone  to  the  profession 
in  the  country,  had  no  hesitation  in  applying  all  at  once  the  eight  lancets  of 
the  cupping  instrument  behind  the  ears  of  infants  under  six  months  old  ;  and 
that,  in  some  cases,  repeatedly  !  In  addition,  they  were  in  the  habit  of  leech- 
ing, purging,  and  parboiling  the  poor  little  creatures  to  death  in  warm  baths  ! 
If'mothers  will  really  suffer  their  children  to  be  treated  in  this*  manner, 
surely  they  only  deserve  to  lose  them.  The  strongest  and  healthiest  child 
in  existence,  far  less  a  sick  one,  could  scarcely  survive  the  routine  practice. 
And  yet,  whether  you  believe  me  or  not,  such  fits  are 

seldom  mortal, 

Save  when  the  doctor's  sent  for ! 

In  my  experience,  it  is  only  when  the  muscles  of  the  wind-pipe  become 
spasmodically  involved,  that  you  have  any  occasion  to  be  anxious  ;  asphyxia 
and  sudden  death  being  sometimes  the  result  of  such  cases.  In  adult  epilepsy, 
especially  at  the  commencement  of  the  fit,  a  very  little  thing  will  often  at 
once  produce  a  counter-movement  of  the  brain,  sufficiently  strong  to  influence 
the  body  in  a  manner  incompatible  with  its  further  continuance.  The  appli- 
cation of  so  simple  a  means  as  the  ligature  may  then  very  often  do  this  at 
once  ;  but,  like  every  other  remedy  frequently  resorted  to,  it  will  be  sure  to 
lose  its  good  effect,  when  the  patient  has  become  accustomed  to  it ;  for  in  this 
and  similar  cases,  every  thing  depends  upon  the  suddenness  and  unexpected- 
ness of  the  particular  measure  put  in  practice,  whether  you  influence  the 
brain  of  a  patient  in  a  novel  manner  or  not.  The  sudden  cry  of  "  fire"  or 
"  murder,"  nay,  the  unexpected  singing  of  some  old  song,  in  a  situation,  or 
under  circumstances  which  surprised  the  person  who  heard  it,  has  charmed 
away  a  paroxysm  of  the  severest  pain.  In  the  army,  the  unexpected  order 
for  a  march  or  a  battle  will  often  empty  an  hospital.  The  mental  excitement 
thereby  produced,  has  cured  diseases  which  had  baffled  all  the  efforts  of  the 
most  experienced  medical  officers.  In  the  words  of  Shakspeare,  then,  you 
may  positively  and  literally 

Fetter  strong  madness  with  a  silken  thread, 
Cure  ache  with  air,  and  agony  with  words  ! 


142  LECTURE  VII. 


LECTURE  VII. 

UNITY  OF  ALL  THINGS— DISEASES  OF  WOMEN — CANCER — TUMOUR — PREG- 
NANCT  —  PARTURITION — ABORTION  —  TEETHING  —  HEREDITARY  PERIO- 
DICITY. 

Gentlemen, 

Many  of  you  have,  doubtless,  read  or  heard  of  Dr.  Charming  of  Bos- 
ton, one  of  the  boldest  and  most  eloquent  of  American  writers.  In  a  little 
essay  of  his,  entitled  ••  Self-Culture,"  I  find  some  observations  bearing  so 
strongly  upon  the  subject  of  these  lectures,  that  I  cannot  resist  the  tempta- 
tion to  read  them  at  length.  How  far  they  go  to  strengthen  the  view  I  bave 
thought  it  right  to  instil  into  your  minds,  you  will  now  haVe  an  opportunity 
of  judging  for  yourselves  : — "  Intellectual  culture,"  says  this  justly  eminent 

f>erson,  "  consists,  not  chiefly,  as  many  are  apt  to  think,  in  accumulating  in- 
brmation,  though  this  is  important ;  but  in  building  up  a  force  of  thought 
which  may  be  turned  at  will  on  any  subjects  on  which  we  are  forced  to  pass 
judgment.  This  force  is  manifested  in  the  concentration  of  the  attention  ;  in 
accurate,  penetrating  observation;  in  reducing  complex  subjects  to  their  ele- 
ments ;  in  diving  beneath  the  effect  to  the  cause  ;  in  detecting  the  more  subtle 
differences  and  resemblances  of  things;  in  reading  the  future  in  the  present; 
and  especially  in  rising  from  particular  facts  to  general  laws  or  universal  truths. 
This  last  exertion  of  the  intellect,  its  rising  to  broad  views  and  great  princi- 
ples, constitutes  what  is  called  a  philosophical  mind,  and  is  especially  worthy 
of  culture.  What  it  means,  your  own  observation  must  have  taught  you.  You 
must  have  taken  note  of  two  classes  of  men  ;  the  one  always  employed  on 
details,  on  particular  facts,  and  the  other  using  these  facts  as  foundations  of 
higher,  wider  truths.  The  latter  are  philosophers.  For  example,  men  had 
for  ages  seen  pieces  of  wood,  stones,  metals  falling  to  the  ground.  Newton 
seized  on  these  particular  facts,  and  rose  to  the  idea  that  all  matter  tends,  or 
is  attracted,  towards  all  matter,  and  then  defined  the  law  according  to  which 
this  attraction  or  force  acts  at  different  distances  ;  thus  giving  us  a  grand  prin- 
ciple, which  we  have  reason  to  think  extends  to,  and  controls,  the  whole 
outward  creation.  One  man  reads  a  history,  and  can  tell  you  all  its  events, 
and  there  stops.  Another  combines  these  events,  brings  them  under  one  view, 
and  learns  the  great  causes  which  are  at  work  on  this  or  another  nation,  and 
what  are  its  great  tendencies,  whether  to  freedom  or  despotism,  to  one  or 
another  form  of  civilisation.  So  one  man  talks  continually  about  the  parti- 
cular actions  of  this  or  that  neighbour,  while  another  looks  beyond  the  acts 
to  the  inward  principle  from  which  they  spring,  and  gathers  from  them  larger 
views,  of  human  nature.  In  a  word,  one  man  sees  all  things  apart  and 
in  fragments,  while  another  strives  to  discover  the  harmony,  connexion,  unity 
of  all." 

That  such  unity,  Gentlemen,  does  actually  and  visibly  pervade  the  whole 
subject  of  our  own  particular  branch  of  science — the  history  of  human  diseases, 
is  a  truth  we  have  now,  we  hope,  placed  equally  beyond  the  cavil  of  the  cap- 
tious and  the  interested.  In  this  respect,  indeed,  we  find  it  only  harmonising 
with  the  history  of  every  other  thing  in  nature.  Rut  in  making  intermit- 
tent fever  or  ague  the  type  or  emblem  of  this  unity  of  disease,  we  must 
beg  of  you,  at  the  same  time,  to  keep  constantly  in  view  the  innumerable 
diversities  of  shade  and  period,  which  different  intermittent  fevers  may  ex- 
hibit in  their  course.     It  has  been  said  offices, 


Fades  non  omnibus  una, 


Nee  diversa  tamen- 


And  tlic  same  may  with  equal  truth  be  said  of  fevers  ;  all  have  resemblances, 
yet  all  have  differences.     For,  betwixt  the  more  subtle  and  slight  thermal 


LECTURE  VII.  143 

departures  from  health — those  scarcely  perceptible  chills  and  heats,  which 
barely  deviate  from  that  state — and  the  very  intense  cold  and  hot  stages 
characteristic  of  an  extreme  fit  of  ague,  you  may  have  a  thousand  differences 
of  scale  or  degree.  Now,  as  it  is  only  in  the  question  of  scale  that  all  things 
can  possibly  differ  from  each  other,  so  also  is  it  in  this  that  all  things  are 
found  to  resemble  each  other.  The  same  differences  of  shade  remarkable  in 
the  case  of  temperature  may  be  equally  observed  in  the  motive  condition  of  the 
muscles  of  particular  patients.  One  man,  for  example,  may  have  a  tremu- 
lous, spasmodic,  or  languid  motion  of  one  muscle  or  class  of  muscles  simply ; 
while  another  shall  experience  one  or  other  of  these  nrbrbid  changes  of  action 
in  every  muscle  of  his  body.  The  chills,  heats,  and  sweats,  instead  of  being 
in  all  cases  universal,  may  in  many  instances  be  partial  only.  Nay,  in  place 
of  any  increase  of  perspiration  outwards,  there  may  be  a  vicarious  supera- 
bundance of  some  other  secretion  within ;  of  this,  you  have  evidence  in  the 
dropsical  swelling,  the  diarrhcea,  the  bilious  vomitings,  and  the  diabetic  flow 
of  urine  with  which  certain  patients  are  afflicted.  In  such  cases,  and  at  such 
times,  the  skin  is  almost  always  dry.  The  same  diversity  of  shade  which 
you  remark  in  the  symptoms,  may  be  equally  observed  in  the  period.  The 
degree  of  duration,  completeness,  and  exactness  of  both  paroxysm  and  remis- 
sion, differs  with  every  case.  The  cold  stage,  which,  in  most  instances,  takes 
the  patient  first,  in  individual  cases  may  be  preceded  by  the  hot.  Moreover, 
aftex  one  or  more  repetitions  of  the  fit,  the  most  perfect  ague  may  become  gra- 
dually less  and  less  regular  in  its  paroxysms  and  periods  of  return  ;  passing 
in  one  case  into  a  fever  apparently  continued ;  in  another,  reverting  by  suc- 
cessive changes  of  shade  into  those  happier  and  more  harmonious  alternations 
of  temperature,  motion,  and  period,  which  Shakspeare,  with  his  usual  felicity, 
figured  as  the  "  fitful  fever"  of  healthy  life.  If  you  take  health  for  the 
standard,  every  thing  above  or  beneath  it,  whether  as  regards  time,  tempera- 
ture, motion,  or  rest,  is  disease.  When  carefully  and  correctly  analysed,  the 
symptoms  of  such  disease,  to  a  physical  certainty,  will  be  found  to  resolve 
themselves  into  the  symptoms  or  shades  of  symptom,  of  intermittent  fever. — 
Fever,  instead  of  being  a  thing  apart  from  man,  as  your  school  doctrines  would 
almost  induce  you  to  believe,  is  only  an  abstract  expression  for  a  greater  or 
less  change  in  the  various  revolutions  of  the  matter  of  the  body.  Fever  and 
disease,  then,  are  one  and  identical.  They  are  neither  "  essences"  to 
extract,  nor  "  entities"  to  combat ;  they  are  simply  variations  in  the  pheno- 
mena of  corporeal  movements  ;  and  in  most  cases,  happily  for  mankind,  they 

may  return  to  their  normal  state  without  the  aid  of  physic  or  physicians 

The  same  reparative  power  by  which  a  cut  or  a  bruise,  in  favourable  circum- 
stances, becomes  healed,  may  equally  enable  every  part  of  a  disordered  body 
to  resume  its  wonted  harmony  of  action.  How  often  has  nature  in  this  way 
triumphed  over  physic,  even  in  cases  where  the  physician  had  been  only  too 
busy  with  his  interference  !  It  is  in  these  cases  of  escape  that  the  generality 
of  medical  men  arrogate  to  themselves  the  credit  of  a  cure. 

"  It  was  a  beautiful  speculation  of  Parmenio,"  remarks  Lord  Bacon, 
"  though  but  a  speculation  in  him,  that  all  things  do  by  scale  ascend  to  unity." 
Do  I  need  to  tell  you,  Gentlemen,  that  everything  on  this  earth  which  can 
be  weighed  or  measured  is  matter — matter  in  one  mode  or  another  !  What 
is  the  difference  betwixt  a  piece  of  gold  and  a  piece  of  silver  of  equal  shape 
and  size  1  A  mere  difference  of  degree  of  the  same  qualities — a  different 
specific  gravity,  a  different  colour,  a  different  ring,  a  different  degree  of  mal- 
leability, a  different  lustre.  But  who  in  his  senses  would  deny  that  these 
two  substances  approach  nearer  in  their  nature  to  each  other  than  a  piece  of 
wood  does  to  a  stone  ;  yet  may  not  a  piece  of  wood  be  petrified,  be  trans- 
formed into  the  very  identical  substance  from  which,  at  first  sight,  it  so  strik- 
ingly differs?  Nay,  may  not  the  bones,  muscles,  viscera,  and  even  the 
secretions  of  an  animal  body,  by  the  same  inscrutable  chemistry  of  nature,  be 
similarly  transmuted  into  stone  ?     Gold  and  silver  have  differences  assuredly,* 


144  LECTURE  VII. 

but  have  they  not  resemblances  also  ;  certain  things  in  common,  from  which 
we  deduce  their  unity,  when  we  speak  of  them  both  as  meials  1  How  much 
more  akin  to  each  other  in  every  respect  are  these  substances  than  water  is  to 
either  of  its  own  elemental  gases  !  What  certainty,  then,  have  you  or  I  that 
both  metals  are  not  the  same  matter,  only  differing  from  each  other  in  their 
condition  or  mode  ?  Does  not  everything  in  turn  change  into  something  else  ; 
the  organic  passing  into  the  inorganic,  solids  into  liquids,  liquids  into  gases, 
life  into  death,  and  vice  versa  ?  The  more  you  reflect  upon  this  subject,  the 
more  you  must  come  to  the  opinion,  that  all  things  at  last  are  only  modes  or 
differences  of  one  matter.  The  unity  of  disease  is  admitted  by  the  very 
opponents  of  the  doctrine,  when  they  give  to  apoplexy  and  toothache  the 
same  name — disease  or  disorder.  But  these  approaches  to  unity  may  be 
traced  throughout  every  thing  in  nature.  Betwixt  the  history  of  the  human 
race,  for  example,  the  revolutions  of  empires,  and  the  history  of  the  individual 
man,  the  strongest  relations  of  affinity  may  be  traced.  The  corporeal  revo- 
lutions of  the  body,  like  the  revolutions  of  a  kingdom,  are  a  series  of  events. 
Time,  space,  and  motion,  are  equally  elements  of  both.  "  An  analyst  or  a 
historian,"  says  Hume,  "who  should  undertake  to  write  the  History  of 
Europe  during  any  century,  would  be  influenced  by  the  connexion  of  time  and 
place.  All  events  which  happen  in  that  portion  of  space  and  period  of  time, 
are  comprehended  in  his  design,  though,  in  other  respects,  different  and  un- 
connected.    They  have  still  a  species  of  unity  amid  all  their  diversity." 

The  life  of  man  is  a  series  of  revolutions.  I  do  not  at  this  moment 
refer  to  the  diurnal  and  other  "minor  movements  of  his  body.  I  allude  now  to 
those  greater  changes  in  his  economy,  those  clbrthcteiic  periods,  at  which, 
certain  organs  that  were  previously  rudimental  and  inactive,  become  succes- 
sively developed.  Such  are  the  periods  of  teething  and  puberty,  and  the  time 
when  he  attains  to  his  utmost  maturity  of  corporeal  and  intellectual  power. 
The  girl,  the  boy,  the  woman,  the  man,  are  all  different,  yet  they  are  the 
same  ;  for  when  we  speak  of  man  in  the  abstract,  we  mean  all  ages  and  both 
sexes.  But  betwixt  the  female  and  the  male  of  all  animals  there  is  a  greater 
degree  of  conformity  or  unity  than  you  would  at  first  suppose,  and  which  is 
greatest  in  their  beginning.  Now,  this  harmonises  with  every  thing  else  in 
nature ;  for  all  things  in  the  beginning  approach  more  nearly  to  simplicity. 
The  early  fatus  of  every  animal,  man  included,  has  no  sex  ;  when  sex  appears, 
it  is  in  the  first  instance  hermaphrodite,  just  as  we  find  it  in  the  lowest  tribe 
of  adult  animals — the  oyster,  for  example.  In  this  particular,  as  in  every  other, 
the  organs  of  the  human  foetus,  internal  as  well  as  external,  first  come  into  exist- 
ence in  the  lowest  animal  type  ;  and  it  depends  entirely  upon  the  greater  or 
less  after  development  of  these  several  hermaphroditic  parts,  whether  the 
organs  for  the  preservation  of  the  race,  take  eventually  the  male  or  female 
form.  How  they  become  influenced  to  one  or  the  other  form  we  know  not. 
Does  it  depend  upon  position  ?  It  must  at  any  rate  have  a  relation  to  tem- 
perature. For  a  long  time  even  after  birth,  the  breasts  of  the  boy  and  the  girl 
preserve  the  same  appearance  precisely.  You  can  see  that  with  your  own 
eyes.  But  the  comparative  anatomist  can  point  out  other  analogies,  other 
equally  close  resemblances  in  the  rudimental  condition  of  the  reproductive 
organs  of  both  sexes.  During  the  more  early  ftetal  state,  the  rudiments  of  the 
testes  and  ovaries  are  so  perfectly  identical  in  place  and  appearance,  that  you 
could  not  tell  whether  they  should  afterwards  become  the  one  or  the  other. — 
What  in  the  male  becomes  the  prostate  gland,  in  the  female  takes  the  form  of 
the  womb.  To  sum  up  all,  the  outward  generative  organs  of  both  sexes  are 
little  more  than  inversions  of  each  other.  Every  hour  that  passes,  however, 
while  yet  in  its  mother's  womb,  converts  more  and  more  the  unity  of  sex  «>f 
the  infant  into  diversity.  But  such  diversity,  for  a  long  period,  even  after 
birth,  is  less  remarkable  than  in  adult  life.  How  difficult  at  first  sight,  to  tell 
the  sex  of  a  child  of  two  or  three  years  old  when  clothed  !  at  puberty,  this  dif- 
.ficuky  has   altogether  vanished.     Then   the  boy  becomes  bearded,  rod  his 


LECTURE  VII.  145 

voice  alters  ;  then  the  breasts  of  the  girl — which  up  to  this  period,  in-  no  re- 
spect different  from  his,  in  appearance  at  least — become  fully  and  fairly 
developed  ;  assuming  by  gradual  approaches  the  form  necessary  for  the  new 
function  they  must  eventually  perform  in  the  maternal  economy.  Another, 
and  a  still  greater  revolution,  embues  them  with  the  power  of  secreting  the 
first  nutriment  of  the  infant.  But  even  before  the  girl  can  become  a  mother 
a  new  secretion  must  have  come  into  play  ;  a  secretion  which,  from  its  period 
being,  unlike  every  other,  monthly  only,  is  known  to  physicians  under  the 
name  of  "  Catamenia,"  or  the  "  Menses."  How  can  such  things  be  done  but 
by  a  great  constitutional  change,  without  a  new  febrile  revolution  of  the  whole 
body  !  Mark  the  sudden  alternate  pallor  and  flush  of  the  cheek  and  lip,  the 
tremors,  spasms,  and  palpitations — to  say  nothing  of  the  uncontrollable  men- 
tal depressions  and  exaltations — to  which  the  girl  is  then  subject ;  and  you 
will  have  little  difficulty  in  detecting  the  type  of  every  one  of  the  numerous 
diseases  to  which  she  is  then  liable.  Physicians  may  call  them  "  Chlorosis," 
"  green-sickness,"  or  any  other  name  ;  you,  Gentlemen,  will  recognize  in  them 
the  developments  of  an  intermittent  fever  simply — as  various  in  its  shades,  it 
is  true,  as  a  fever  from  any  other  cause  may  become — producing,  like  that, 
every  wrong  action  of  place  and  time  you  can  conceive,  and,  like  other  fevers, 
often  curing  such  wrong  actions  as  previously  existed,  when  it  happens  to 
reverse  the  atomic  motions  of»the  various  parts  of  the  body.  Before  touching 
upon  the  principal 

Diseases  incidental  to  Women, 

I  must  tell  you  that  the  Catamenial  secretion,  in  most  cases,  disappears 
during  the  period  of  actual  pregnancy  ;  nor  does  it  return  while  the  mother 
continues  to  give  suck.  During  health,  in  every  other  instance,  it  continues 
from  the  time  of  puberty,  or  the  period  when  women  can  bear  children,  to 
the  period  when  this  reproductive  power  ceases.  As  with  a  Fever  it  comes 
into  play,  so  with  a  Fever  it  also  takes  its  final  departure.  Why  it  should 
be  a  peculiarity  of  the  human  female,  I  do  not  know, — but  in  no  other  ani- 
mal has  anything  analogous  been  observed.  Some  authors,  indeed,  pretend 
to  have  seen  it  in  the  monkey  ;  but  if  this  were  really  the  case,'  I  do  not  think 
so  many  physiologists  would  still  continue  to  doubt  it,  especially  as  they 
have  every  opportunity  of  settling  the  question  definitively.  Various  specu- 
lations have  been  afloat  as  to  the  uses  of  this  secretion,  but  I  have  never  been 
satisfied  of  the  truth  of  any  of  them.  I  am  better  pleased  to  know,  that  the 
more  perfect  the  health,  the  more  perfectly  periodical  the  recurrence  of  the 
phenomenon.  It  is,  therefore,  without  question,  a  Secretion,  and  one  as  natu- 
ral and  necessary  to  females  of  a  certain  age,  as  the  saliva  or  the  bile  to  all 
people  in  all  times.  How  absurd,  then,  the  common  expression  that  a  wo- 
man, during  her  period,  is  "  unwell !"  It  is  only  when  the  catamenia  is  too 
profuse  or  too  defective  in  quantity,  or  too  frequent,  or  too  far  between  in  the 
period, — when  trie  quality  must  also  be  correspondingly  altered, — that  the 
health  is  in  reality  impaired.  Then,  indeed,  as  in  the  case  of  other  secre- 
tions imperfectly  performed,  pain  may  be  an  accompaniment  of  this  particu- 
lar function. 

Need  I  tell  you,  that  no  female  of  a  certain  age  can  become  the  subject  of 
any  Fever  without  experiencing  more  or  less  change  in  this  catamenia  ?  or 
that  during  any  kind  of  indisposition,  how  slight  soever  it  may  be,  some  cor- 
responding alteration  in  this  respect  must,  with  equal  certainty,  take  place  ? 
In  cases  where  the  alteration  thus  produced  takes  the  shape  of  a  too  profuse 
flow,  practitioners  are  in  the  habit  of  prescribing  astringents  and  cold  appli- 
cations. Happily  for  the  patient,  the  medicines  usually  styled  "  Astringents," 
(iron,  bark,  alum,  opium,  &c.,)  are  all  chrono-thermal  in  their  action ; 
and  the  general  salutary  influence  which  they  consequently  exercise  over  the 
whole  economy,  very  frequently  puts  the  catamenia,  in  common  with  every 


146  LECTURE  VII. 

other  function,  to  rights, — when  the  practitioner  who  prescribes  them  has  no 
idea  that  he  is  doing  more  than  attending  to  the  derangement  of  a  part.  He 
accordingly  places  profuse  menstruation  in  his  list  of  local  diseases  !  When 
deficiency  or  suppression  of  this  secretion,  on  the  contrary,  chances  to  be  the 
coincident  feature  of  any  general  constitutional  change, — a  thing  which  may 
happen  from  a  transitory  passion  even, — such  effect  or  coincidence  of  cerebral 
disturbance  is  by  many  practitioners  assumed  to  be  the  cause  of  all  the  other 
symptoms  of  corporeal  derangement!  And  under  the  formidable  title  of  "ob- 
struction," how  do  you  think  some  of  your  great  accoucheur-doctors  are  in 
the  habit  of  combating  it  ?  By  leeching  the  patient — by  applying  leeches 
locally.  Now,  I  only  ask  you  what  you  would  think  of  a  practitioner,  who, 
on  finding  the  same  patient  feverish  and  thirsty,  should  leech  her  Tongue  ? 
or  when  she  complained  of  her  Skin  being  uncomfortably  dry,  should  apply 
leeches  to  that  ?  You  would  laugh  at  .him  of  course  ;  and  so  you  may,  with 
just  the  same  reason,  laugh  at  the  fashionable  practitioners  of  the  day,  when 
you  find  them  leeching  their  patients  for  defective  or  suppressed  menstrua- 
tion,— a  derangement  of  function  which  a  Passion  might  produce,  and  another 
restore  to  its  healthy  state.  Is  it,  then,  a  local  disease,  or  a  disease  of  the 
brain  and  nerves — an  affection  of  a  part  or  a  disorder  of  totality  ?  If  the 
latter,  who  but  a  mechanic  would  think  of  applying  leeches  locally  ?  In 
either  case,  who  but  a  cow-leech  or  a  quack-salver  would  dream  of  restoring 
any  periodical  secretion  by  a  mode  of  practice  so  barbarous  and  disgusting  ? 
You  might  just  as  reasonably,  in  the  absence  of  an  appetite  for  dinner,  expect 
to  make  your  "  mouth  water"  by  the  application  of  leeches  to  your  gullet 
when  the  clock  should  strike  five  ! 

Having  thus  far  explained  the  nature  of  these  cases,  I  have  now  little  else 
to  say  of  them.  The  general  principle  of  treatment  is  obvious — attention  to 
temperature  ;  for,  in  every  case  of  catamenial  irregularity,  whether  as  regards 
Quantity,  Quality,  or  Period,  the  temperature  of  the  loins  must  be  more  or 
less  morbid, — one  patient  acknowledging  to  chill,  another  to  heat.  In  the 
former  case,  friction  or  a  warm  plaster  may  be  tried  as  a  local  means — in  the 
latter,  cold  or  tepid  sponging ;  though  I  may  tell  you,  that,  with  the  chrono- 
thermal  remedies  singly,  you  may  produce  the  most  salutary  results  in  nu- 
merous cases.  In  both  instances,  cold,  warm,  and  tepid  baths  may  also  be 
advantageously  employed,  according  to  the  varying  circumstances  of  the 
case. 

The  majority  of  women  who  suffer  from  any  general  indisposition  short  of 
Acute  Fever,  are  more  or  less  subject  to  a  particular  discharge  which,  by  the  pa- 
tients themselves,  is  very  often  termed  Weakness,  but  which  is  more  familiar  to 
the  profession  under  the  name  of  Leucorrhcea  or  Whites.  The  usual  concomit- 
ant of  this  disease  is  a  dull  aching  pain  at  the  lower  part  of  the  back.  Now,  I 
never  questioned  a  woman  who  suffered  from  it,  but  she  at  once  acknow- 
ledged that  the  local  flow  was  one  day  more,  another  less,  and  that  she  had, 
besides,  the  chills,  heats,  and  other  symptoms  of  general  constitutional  de- 
rangement. But  of  that  derangement,  the  discharge  so  oFen  supposed  to  be 
the  cause,  is,  in  the  first  instance,  nothing  more  than  a  coincident  /<  ature  or 
effect ;  though,  from  pain  or  profusencss,  it  may  re-act  upon  the  constitution 
at  large,  and  thus  form  a  secondary  and  superadded  cause  or  aggravant.  In 
cases  of  this  kind  I  am  in  the  practice  of  prescribing  quinine,  iron,  or  alum, 
sometimes  with,  and  sometimes  without,  copaiba,  catechu,  or  cantharides — 
one  medicine  answering  best  with  one  patient,  another  with  amain  r. 

I  have  been  frequently  consulted  in  cases  of  painful  Whites,  and  also  in 
cases  of  painful  menstruation,  disorders  which  practitioners,  as  remarkable 
for  their  professional  eminence,  as  for  their  utter  want  of  high  prof 
knowledge,  had  been  previously  treating  by  leeches  ;  some  applying  these  to 
the  loins,  which,  in  every  case,  whether  of  whites  or  irregular  mensti 
is  weak,  and,  consequently,  painful ;  some,  to  the  disgust  of  every  woman  ol 
sensibility,  introducing  them  even  to  the  orifice  of  the  womb  itself.     What 


LECTURE  VII.  147 

practice  can  be  more  erroneous  ?  What  relief,  if  obtained,  more  delusive  ? 
Bark,  iron,  opium, — these  are  the  remedies  for  cases  of  this  description  ;  and 
the  general  constitutional  improvement  which,  for  the  most  part,  follows  their 
use,  together  with  the  disappearance  of  the  more  prominent  local  irregulari- 
ties for  which  your  aid  had  been  asked,  affords  the  best  answer  to  any  hypo- 
thetic  objection  that  may  be  brought  against  their  employment.  The  best 
topical  application  in  these  cases — and  you  will  find  it  useful  in  most — is  a 
plaster  to  the  spine  to  warm  and  support  it ;  though  cold,  hot,  or  tepid 
fomentation  to  the  loins  or  womb  may  also  be  occasionally  employed,  accord- 
ing as  one  or  other  shall  prove  most  agreeable  to  the  patient's  own  feelings. 

The  various  female  disorders  of  which  I  have  just  been  treating  are  mat- 
ter of  daily  practice.  The  more  formidable  affection  to  which  I  now  draw 
your  attention, 

Cancer  of  the  Breast, 

fortunately  for  the  sex,  is  of  rare  occurrence  ;  not  one  woman,  perhaps,  in 
five  thousand  ever  becoming  the  subject  of  it.  Now,  what  is  cancer  ?  What 
but  a  slow  and  painful  decomposition ;  a  canker  or  blight  o'f  the  particular 
organ  affected  ?  The  manner  in  which  cancer  of  the  breast  generally  com- 
mences is  this  : — A  tumour,  at  first  smaller  than  a  nut,  possessing  more  or 
less  hardness,  and  to  a  certain  extent  circumscribed,  is  observed  in  the  neigh- 
bourhood of  the  nipple  ;  the  patient's  attention,  in  most  cases,  being  called  to 
it  by  a  slight  itching  or  uneasiness  in  the  part  affected,  which  soon  deepens 
into  a  "  pricking,"  "  darting,"  or  "  shooting"  pain  ;  for  such  are  the  various 
phrases  by  which  different  patients  describe  their  pain.  This  tumour  slowly 
but  gradually  increases  in  size  and  hardness,  while  the  pain  becomes  more 
and  more  intolerable  and  "  lancinating."  The  disease  in  every  case  is  inter- 
mittent, and  in  most  instances,  this  intermission  is  periodical,  the  tumour  be- 
ing one  day  perceptibly  diminished,  another  as  obviously  enlarged.  The 
pain,  in  like  manner,  disappears  more  or  less  completely,  for  a  time,  to  return 
at  a  particular  hour  of  the  clock  with  undiminished  violence.  Now,  when 
surgeons  were  more  in  the  habit  of  performing  operations  in  cases  of  this  kind, 
than  at  present,  such  tumours,  after  removal  by  the  knife,  were  usually,  from 
motives  of  curiosity,  bisected.  If  their  internal  structure,  when  thus  divided, 
resembled  something  betwixt  a  turnip  and  a  cartilage,  the  disease  was  pro- 
nounced to  be  "  true  cancer" — a  schirrhus  or  carcinoma.  On  the  contrary, 
if,  instead  of  this  appearance,  the  tumour  had  a  resemblance  to  the  substance 
of  the  brain,  or  to  lard,  jelly,  or  was  of  a  mixed  character,  disputes  frequently 
arose  as  to  the  name  by  which  the  disease  should  be  christened  ;  as  if  it  signified 
one  straw  whether  the  breast,  when  as  completely  changed  in  its  structure 
and  nature,  as  to  be  productive  of  nothing  but  misery  to  its  owner,  should  be 
called  schirrus,  carcinoma,  cancer,  or  anything  else !  Oh  !  it  matters  very 
little  what  that  organic  change  be  termed,  when,  as  in  all  these  cases, 
the  glandular  fabric  of  the  breast  becomes  at  last  completely  destroyed  and 
decomposed. 

How  and  in  what  manner  is  this  disease  developed  ?  Gentlemen,  it  is  the 
result  of  general  constitutional  change.  It  is  the  effect  of  a  weak  action  of  the 
nerves  on  an  originally  weak  organ ;  and  of  this  you  may  be  satisfied,  when 
I  tell  you  that  in  most  instances  cancer  is  a  hereditary  disease  ;  or,  to  express 
myself  better,  there  is  hereditary  predisposition;  and  what  is  more,  the  dis- 
ease generally  makes  its  first  appearance  about  that  period  of  life,  when  the 
breast  ceases  to  be  anything  but  a  mere  personal  ornament  to  its  possessor. 
It  comes  on  much  about  the  time  when  the  catamenial  secretion  is  about  to 
terminate  for  life.  Can  such  termination  take  place  without  a  new  corporeal 
revolution  ?  Impossible  !  at  this  epoch  every  female  suffers  more  or  less 
from  constitutional  disorder.  Analyse  that  disorder,  and  you  will  find  that  it 
resolves  itself  into  a  general  intermittent  febrile  action  of  the  whole  body, 
varying  in  its  shade  Avith  every  case.  Cancer,  then,  is  a  development  of  that 
fever.     Now,  why  is  it  that  the  word  "  Cancer"  sounds  so  fearfully  to  tho 


148  LECTURE  VII. 

female  ear  ?  The  difficulty  to  cure  it,  simply— the  difficulty  in  most  instances 
— the  absolute  impossibility  in  many.  To  understand  the  reason  of  this  dif- 
ficulty, we  must  consider  the  nature  and  uses  of  the  organ.  However  beau- 
tiful and  ornamental,  the  breast  is  not,  like  the  heart  or  lungs,  an  organ  of 
importance  to  the  vital  economy  of  the  individual.  It  is  a  part  superadded 
for  the  preservation  of  the  race.  Rudimental,  or  all  but  absent,  in  the  child, 
this  organ  only  reaches  its  full  maturity  of  development  when  the  girl  becomes 
the  woman.  After  the  woman  ceases  to  bear  children,  or  whether  she  has 
borne  them  or  not,  when  the  period  of  the  possibility  of  her  being  pregnant 
has  passed  away,  the  substance  of  the  breast  is  generally  more  or  less  ab- 
sorbed ;  though  you  occasionally  meet  with  instances  where  it  becomes 
enlarged  beyond  its  previous  size.  In  fewer  cases  still,  it  takes  on  a  process  of 
decay  ;  in  other  words,  it  becomes  cancerous.  But  nature  in  this  instance, 
even  when  aided  by  art,  will  not  often  exert  her  usual  reparative  efforts  :  she 
will  not  put  forth  her  powers  (so  to  speak)  for  the  preservation  of  a  part 
which  now,  not  only  so  far  as  the  individual  economy  is  concerned,  but  so 
far  also  as  regards  the  race,  has  become  a  useless  part.  This  I  take  to  be 
the  true  reason  of  the  difficulty  to  cure  a  cancer  ;  for  although  in  many  cases 
more  or  less  improvement  of  the  affected  organ  may  follow  the  employment  of 
remedial  means — such  means  as  beneficially  influence  the  whole  health — still, 
as  if  to  prove  more  fully  the  truth  of  my  explanation,  you  may  even  succeed 
to  a  great  extent  in  raising  the  general  healthy  standard,  and  yet  fail  to  pro- 
cure the  slightest  arrest  of  the  local  process  of  decay.  While  a  cut  or  bruise 
upon  any  other  part  of  the  body  of  a  cancer  patient  will  heal  with  ease,  the 
breast,  partaking  no  longer  in  the  preservative  power  of  the  economy,  may 
perish  piece-meal.  Gentlemen,  never  in  my  life  did  I  meet  with  a  cancer  in 
any  state  or  stage,  the  subject  of  which  did  not  acknowledge  to  chills  and  heats, 
or  who  did  not  admit  errors  of  secretion  ;  to  say  nothing  of  variations  in  the 
volume,  temperature,  and  sensation  of  the  part  affected.  I  lately  attended 
the  sister  of  a  Fellow  of  the  College  of  Physicians,  who  was  first  induced  to 
consult  me,  from  hearing  that  I  looked  upon  ague  as  the  primary  type  or 
model  of  all  complaints.  Her  own  cancer,  she  assured  me,  was  preceded  by 
shivering  fits,  which  she  traced  to  a  sudden  chill ;  and  during  the  whole  pro- 
gress of  the  disease,  she  suffered  more  or  less  from  agueish  feelings.  Previ- 
ously to  my  seeing  her,  she  had  been  visited  by  a  surgeon  of  eminence,  who 
ordered  her  to  apply  leeches ;  but  the  effect  of  their  employment  was  an  in- 
crease of  her  pain.  And  no  wonder ;  for  if  that  eminent  person  had  only 
taken  the  trouble  to  inquire,  he  would  have  found  that,  instead  of  the  hypo- 
thetic "inflammation,"  which  doubtless  suggested  their  employment,  the 
breast  in  that  instance  was  generally  cold !  Would  not  a  warm  plaster, 
under  these  circumstances,  have  been  of  more  service  ?  You,  Gentlemen, 
may  try  it  at  least,  and  if  you  do  not  find  it  produce  more  or  less  relief  in 
many  similar  instances,  I  know  nothing  whatever  of  the  science  I  now  pretend 
to  teach  you.  No  local  application,  however,  will  be  long  productive  of  anv 
very  effectual  advantage  in  this  or  any  other  disease,  without  attending  to  thf 
chrono-thermal  principles  of  paroxysm  and  remission.  Arsenic,  quinine, 
opium,  copper,  prussic  acid,  may  all  be  successively  tried.  But  you  mus 
here  always  keep  in  mint!  that  cancer  is  a  chronic  disease,  a  disease  of  time, 
and  you  must  farther  hold  in  your  remembrance  what  I  have  already  said  ii 
regard  to  most  cases  of  chronic  disease,  namely,  that  no  medicine  will  pro 
duce  its  beneficial  effect  foi  any  great  continuance  in  those  disorders  ;  onco 
the  constitution  becomes  accustomed  to  the  use  of  a  remedy,  such  remedy 
cither  loses  its  salutary  influence  altogether,  or  acts  in  a  manner  the  reverse 
of  that  which  it  did  when  tried  in  the  first  instance. 

No  medicinal  agent  had  a  greater  reputation  at  one  time,  in  the  treatment 
of  Cancer,  than  arsenic  ;  arseni :,  in  fact,  was  supposed  to  be  a  wonderful 
specific  in  cases  of  that  nature.  What  was  the  consequence  1  Like  every 
thing  else  in  this  world,  whether  person  or  thing,  phybician  or  physic,  that 


LECTURE  VII.  149 

ever  enjoyed  the  temporary  distinction  of  infallibility,  after  a  few  decided 
failures  in  particular  instances,  this  mineral  came  at  last  to  be  almost  entirely 
abandoned  in  such  cases.  And  yet,  notwithstanding  this,  I  do  not  know  a 
remedy  which  may  be  more  successfully  used  in  Cancer  than  arsenic.  "  We 
have  seen  from  its  use,"  says  Dr.  Parr  in  his  Dictionary,  published  in  ]  809,  "  an 
extensive  [cancerous]  sore  filled  with  the  most  healthy  granulations,  the 
complexion  become  clear,  the  appetite  improved,  and  the  general  health  in- 
creased. Unfortunately,  (he  continues,)  these  good  effects  have  not  been 
permanent.  By  increasing  the  dose  we  have  gained  a  little  more,  but  "at  last, 
these  advantages  were  apparently  lost."  And  was  it  ever  otherwise  with 
any  other  remedy  ?  No  power  on  earth  could  always  act  upon  the  living 
body  in  the  same  manner.  The  strongest  rope  will  strain  at  last ;  and  so 
will  the  best  medicine  cease,  after  a  time,  to  do  the  work  it  did  at  first.  But 
a  physician  who  should,  on  that  score,  despise  or  decry  a  power  that  had, 
for  a  given  time,  proved  decidedly  advantageous  in  any  case,  would  be  just 
as  wise  as  the  traveller,  who,  on  reaching  his  inn,  instead  of  being  thankful  to  his 
horse  for  the  ground  it  had  enabled  him  to  clear,  should  complain  of  it  for  not 
carrying  him  without  resting  to  the  end  of  his  journey  !  What,  under  the 
circumstances  mentioned  by  Dr.  Parr,  either  he  or  any  other  doctor  should 
have  done,  and  what  I  have  confidence  in  recommending  you  to  do  on  every 
similar  occasion,  is  this, — Having  obtained  all  the  good  which  arsenic  or  any 
other  remedy  has  the  power  to  do  in  any  case,  change  such  remedy  for  some 
other  constitutional  power,  and  change  and  change  until  you  find  improve- 
ment to  be  the  result ;  and  when  such  result  no  longer  follows  the  employ- 
ment of  your  medicine,  change  it  again  for  some  other  ;  you  may  even  again 
recur  with  the  best  effect  to  one  or  more  of  the  number  you  had  formerly 
tried  with  benefit;  for  when  (if  I  may  speak  so  metaphorically)  the  consti- 
tution has  been  allowed  time  to  forget  a  remedy,  that  once  beneficially  influ- 
enced it,  such  remedy,  like  the  re-reading  of  a  once-admired,  but  long-forgot- 
ten book  on  the  mind,  may  come  upon  the  corporeal  economy  once  more  with 
much  of  its  original  force  and  freshness.  In  all  such  cases,  then,  you  must 
change,  combine,  and  modify  your  medicines  and  measures  in  a  thousand 
ways  to  produce  a  sustained  improvement.  Arsenic,  gold,  iron,  mercury, 
creosote,  iodine,  opium,  prussic  acid,  &c,  may  be  all  advantageously  em- 
ployed, both  as  internal  remedies  and  as  local  applications,  according  to  the 
changing  indications  of  the  case. 

When  cancer  is  suffered  to  run  its  course  undisturbed  by  the  knife  of  the 
surgeon,  or  the  physic  of  the  doctor,  the  usual  termination  of  it  is  this — A 
small  ulcer  shows  itself  upon  the  skin  of  the  most  prominent  part  of  the 
tumour,  gradually  increasing  in  dimension.  And  so  exceedingly  weak  do  the 
atomic  attractions  of  the  matter  of  the  breast  become  during  the  change  pro- 
duced by  the  disease,  that  scarcely  has  the  atmospheric  air  been  allowed  to 
eome  in  contact  with  the  tumour,  than  it  commences  to  mortify  and  die — 
falling  away  in  most  cases,  (as  it  did  indeed  in  the  case  of  the  lady  to  which 
I  have  already  alluded,)  after  a  certain  time  in  a  dead  and  corrupted  mass. 
The  ulcer  which  it  leaves  behind,  is,  in  all  such  cases,  extremely  foetid,  and 
shows  a  great  disposition  to  spread  ;  the  reason  of  which  is  this, — first,  be- 
cause the  whole  constitution  of  such  persons  is  more  or  less  weak  ;  and 
secondly,  because  the  particles  of  dead,  or  half-dead  matter,  which  coat  the 
bowl  of  the  ulcer,  not  only  have  no  power  of  reparation  in  themselves,  but 
are  the  cause  of  a  further  failure  of  reparative  power  in  the  already  weak 
parts  with  which  they  come  in  contact.  Exactly  the  same  thing  takes  place 
when  any  part  of  an  old  tree  becomes  decayed  ;  and  very  much  after  the 
manner  of  such  vegetable  decay,  as  you  may  see  it  in  a  gnarled  oak,  we  have 
in  this  disease  mushroom-like  and  other  excrescences  springing  from  the  sides 
and  bottom  of  the  ulcerous  and  decaying  part,  and  that  too  with  a  rapidity 
truly  astonishing.  A  case  of  this  kind  I  lately  attended  with  Mr.  Farquhar 
of  Albemarle  Street.     Unless  every  nortion  of  these  fungoid  bodies  be  com- 


150  LECTURE  VII. 

pletely  removed,  you  must  not  hope  to  arrest  the  progress  of  the  disease 
The  whole  surface  of  the  ulcer  should  be  cauterised  and  completely  destroyed 
with  a  burning-iron,  nitrate  of  silver,  ammonia,  or  potass.  All  four  may,  in 
some  cases,  be  resorted  to  with  advantage.  Nor  must  you  here  spare  any 
part  that  shows  even  a  symptom  of  weakness  ;  but  cauterise,  and  cauterise 
again  and  again,  until  you  get  red,  small,  healthy  granulations  to  appear. 
The  dressings  which  you  will  now  find  most  successful,  are  ointments  01 
other  preparations  of  the  red  oxide  of  mercury,  iodine,  arsenic,  creosote,  lead, 
&c. ;  and  each  and  all  of  these  will  only  prove  beneficial  in  particular  cases, 
and  for  particular  periods.  The  law  that  holds  good  in  the  case  of  internal 
remedies,  will  be  now  more  conspicuous  in  the  case  of  external  applications, 
— namely,  that  all  medicinal  powers  have  a  certain  relation  to  persons  and 
periods  only,  and  must  in  no  case  be  a  priori  expected  to  do  more  than  pro- 
duce a  temporary  action.  If  that  action  be  of  a  novel  kind,  they  will  pro- 
duce beneficial  results ;  if,  on  the  contrary,  the  increased  motion  from  their 
action  be  in  the  old  direction,  and  which  cannot  be  foreseen  till  tried,  the  re 
suit  of  such  trial  will  be  a  greater  or  less  aggravation  of  the  state  for  whose 
improvement  vou  ordered  them  to  be  applied. 

Dr.  Abel  Stuart,  while  practising  in  the  West  Indies,  where  the  disease  is 
more  frequent  than  in  England,  had  many  opportunities  of  making  himself 
acquainted  with  every  one  of  the  various  states  and  stages  of  Cancer — and 
since  I  settled  in  London,  where  he  also  now  practises,  he  has  shown  me 
cases  of  this  kind,  which  he  has  treated  with  the  greatest  success.  You  must 
not  then  suppose,  like  most  of  the  laity,  and  not  a  few  of  the  members  of  the 
profession,  that  Cancer  of  the  Breast  is  necessarily  a  mortal  disease.  So  long 
as  you  can  prevent  the  ulcer  from  spreading,  and  at  the  same  time  keep  up 
the  general  health  to  a  certain  mark,  how  can  there  be  danger  ?  The  Breast, 
I  repeat,  is  not  a  strictly  vital  organ ;  it  is  not  necessary  to  the  individual  life, 
— it  is  a  part  superadded  for  the  benefit  of  another  generation.  How  many 
women  at  one  time  remarkable  for  a  large  full  bosom,  have  in  the  course  of 
years,  lost  every  appearance  of  breast  by  the  slow  but  imperceptible  process 
of  interstitial  absorption ; — what  inconvenience  do  these  suffer  in  consequence? 
But  for  the  tendency  to  spread,  and  the  accompanying  pain,  Cancer  would 
seldom  terminate  fatally  at  all ;  it  is  the  pain  principally  that  makes  the 
danger,  not  any  loss  of  the  organ  itself.  Pain  alone  will  wear  out  the  strong- 
est :  relieve  this  in  every  way  you  can,  but  avoid  leeches  and  depletion, 
which,  I  need  not  say,  are  the  readiest  means,  not  only  to  exhaust  the  pa- 
tient's strength,  but  to  produce  that  extreme  sensibility  of  nerve,  that  intol- 
erance of  external  impression,  which  converts  the  merest  touch  into  the  stab 
of  a  dagger.  Strong  people  seldom  complain  of  pain  ;  it  is  bloated  or  emacia- 
ted persons  who  mostly  do  so.  Keep  up  the  health,  then,  by  every  means  in 
your  power,  and  your  patient  may  live  as  many  years  with  a  Cancer  of  the 
Breast,  as  if  she  had  never  suffered  from  such  a  disease.  Sir  B.  Brodie 
mentions  the  case  of  a  lady  who  lived  twenty  years  with  Cancer,  and  died  at 
last  of  an  affection  of  the  lungs,  with  which  he  says  it  had  no  necessary  con- 
nexion. What  shall  I  tell  you  in  regard  to  amputation  of  the  Breast  ?  Will 
amputation  harmonise  the  secretions  ?  Will  it  improve  the  constitution  in 
any  way  whatever  ?  Those  patients  who,  in  the  practice  of  others  have 
been  induced  to  undergo  operations,  have  seldom  had  much  cause  to  thank 
their  surgeons, — the  disease  having,  for  the  most  part,  reappeared  at  a  future 
period  in  the  cicatrix  of  the  wounded  part.  Gentlemen,  you  have  only  to  look 
at  the  pallid,  bloated,  or  emaciated  countenances  of  too  many  of  the  sufferers, 
to  be  satisfied  that  something  more  must  be  done  for  them  than  a  mere  surgi- 
cal operation, — a  measure  at  the  best  doubtful  in  most  cases,  and  fatal 'in  not 
a  few.  Shiverings,  heats,  and  sweats,  or  diarrhiea,  or  dropsy,-r-the6e  are  the 
constitutional  signs  that  tell  you  you  have  somothin<,'  more  to  do  than  merely 
dissect  away  a  diseased  structure, — which,  structure,  so  far  from  being  the 
cause,  was  in  reality  but  one  feature  of  a  great  totality  of  infirmity.     That 


LECTURE  VII.  151 

the  knife  may  sometimes  be  advantageously  employed  I  do  not  deny,  but  in- 
stead of  being  the  rule,  it  should  be  the  exception ;  the  majority  of  honoura- 
ble and  enlightened  surgeons  will  admit  how  little  it  bas  served  them  in  most 
cases  beyond  the  mere  purpose  of  temporary  palliation.  When  you  hear 
a  man  now-a-days  speaking  of  the  advantage  of  early  operating,  you  may 
fairly  accuse  him  of  ignorance,  with  which,  I  regret  to  say,  interest,  in  this 
instance,  may  occasionally  go  hand  in  hand.  The  fee  for  amputating  a  breast 
enters  into  the  calculation  of  some  operators. 

I  have  twice  in  my  life  seen  Cancer  of  the  male  Breast — the  subject  of  one 
was  a  European,  the  other  a  native  of  India. 

Let  me  now  say  a  few  words  on 

Tumors 

generally ;  premising  that  the  term  "  Tumor"  is  merely  the  Latin  word  for 
any  Swelling,  though  we  usually  employ  it  in  the  more  limited  sense  of  a 
morbid  growth.  It  is  a  very  common  error  on  the  part  of  medical  men,  to 
state  in  their  reports  of  cases,  that  a  "  healthy"  person  presented  himself 
with  a  particular  tumor  in  this  or  that  situation.  Now,  such  practitioners  by 
this  very  expression  show  how  much  they  have  busied  themselves  with  arti- 
ficial distinctions — distinctions  which  have  no  foundation  in  nature  or  reason 
— to  the  neglect  of  the  circle  of  actions  which  constitute  the  state  of  the  body 
termed  Health.  Never  did  a  tumor  spring  up  in  a  perfectly  healthy  subject. 
In  the  course  of  my  professional  career,  I  have  witnessed  Tumors  of  every 
description,  but  I  never  met  one  that  could  not  be  traced,  either  to  previous 
constitutional  disturbance,  or  to  the  effect  of  local  injury  on  a  previously  un- 
healthy subject.  Chills  and  heats  have  been  confessed  to  by  almost  every 
patient,  and  the  great  majority  have  remembered  that  in  the  earlier  stages 
their  Tumor  was  alternately  more  or  less  voluminous. 

Every  individual,  we  have  already  shown,  has  a  predisposition  to  disease 
of  a  particular  tissue.  Whatever  shall  derange  the  general  health  may  de- 
velope  the  weak  point  of  the  previously  healthy,  and  this  may  be  a  tendency 
to  Tumor  in  one  or  more  tissues.  The  difference  in  the  organic  appearance 
of  the-  different  textures  of  the  body,  will  account  for  any  apparent  differences 
betwixt  the  Tumors  themselves  ;  and  where  Tumors  appear  to  differ  in  the 
same  tissue,  the  difference  will  be  found  to  be  only  in  the  amount  of  the  mat- 
ter entering  into  such  tissue,  or  in  a  new  arrangement  of  some  of  the  elemen- 
tary principles  composing  it.  It  is  a  law  of  the  animal  economy,  that  when 
a  given  secretion  becomes  morbidly  deficient,  some  other  makes  up  for  it  by 
a  preternatural  abundance.  If  you  do  not  perspire  properly,  you  will  find 
the  secretion  from  the  kidneys  or  some  other  organ  increase  in  quantity.  I 
was  consulted  some  time  ago  by  a  female  patient,  whose  bosom  became 
enormous  from  excess  of  adipose  or  fatty  deposit.  Now,  in  the  case  of  this 
female,  the  urine  was  always  scanty,  and  she  never  perspired.  Every  tissue 
of  the  body  is  built  up  by_  secretion.  The  matter  of  muscle,  bone,  and  skin, 
is  fluid,  before  it  assumes  the  consistence  of  a  tissue,  and  the  atoms  of  one 
texture  are  constantly  passing  into  some  other.  "  The  great  processes  of 
nature,"  says  Professor  Brande,  "  such  as  the  vegetation  of  trees  and  plants, 
and  the  phenomena  of  organic  life  generally,  are  connected  with  a  series  of 
chemical  changes."  But,  Gentlemen,  this  chemistry  is  of  a  higher  kind  than 
the  chemistry  of  the  laboratory  ;  it  is  Vital  Chemistry,  under  the  influence, 
as  I  shall  afterwards  show  you,  of  Vital  Electricity.  Secretion  of  every 
kind  is  the  effect  of  this  vital  chemistry  ;  and  Tumors,  instead  of  being  pro- 
duced, as  Mr.  Hunter  supposed,  by  the  "  organisation  of  extravasated  blood," 
are  the  result  of  errors  of  secretion.  They  are  principally  made  up  of  excess 
of  some  portion  of  the  tissue  in  which  they  appear,  or  the  result  of  new  com- 
binations of  some  of  the  ultimate  principles  which  enter  into  its  composition. 

If  you  search  the  records  of  Medicine  upon  the  subject  of  Tumors,  you 
will  find  that  the  agents  by  which  these  have  been  cured  or  diminished,  come 


152  LECTURE  VII. 

at  last  to  the  substances  of  greatest  acknowledged  efficacy  in  the  treatment 
of  ague.  One  practitioner  (Carmichacl)  lauds  Iron  ;  another  (Alibert)  speaks 
favourably  of  the  Baric ;  the  natives  of  India  prefer  Arsenic ;  while  most 
practitioners  have  found  Iodine  and  Mercury  more  or  less  serviceable  in  their 
treatment.  Gentlemen,  do  you  require  to  be  told  that  these  substances  have  all 
succeeded  and  failed  in  ague  !  Marvel  not,  then,  if  each  has  one  day  been 
lauded,  another  decried,  for  every  disease  which  has  obtained  a  name,  Tumors 
of  every  description  among  the  number.     We  now  comeKo 

Pregnancy. 

But  this,  you  will  very  likely  say,  is  not  a  disease.  In  that  case,  I  must 
beg  to  refer  you  to  ladies  who  have  had  children,  and  I  will  wager  you  my 
life,  that  they  will  give  you  a  catalogue  of  the  complaints  that  affected  them 
during  that  state,  equal  in  size  to  Cullen's  Nosology.  In  the  case  of  every 
new  phenomenon  in  the  animal  economy,  whether  male  or  female,  there  must 
be  a  previous  corporeal  revolution.  We  find  this  to  be  the  case  at  the 
periods  of  Teething  and  Puberty — and  so  we  find  it  in  the  case  of  Pregnancy. 
Can  the  seedling  become  an  herb  in  the  frost  of  winter,  or  the  sapling  grow 
to  maturity  without  a  series  of  changes  in  the  temperature  and  motion  of  the 
surrounding  earth  ?  No  more  can  the  fetal  germ  become  the  infant  without 
a  succession  of  febrile  revolutions  in  the  parent  frame  !  Once  in  action,  it 
re-acts  in  its  turn. 

The  influence  of  the  mother's  Brain  over  the  growth  of  the  child  while  in 
the  womb,  is  sufficiently  proved  by  the  effects  of  frights  and  other  passions, 
induced  by  the  sight  of  objects  of  horror,  and  so  forth,  while  in  the  pregnant 
state.  Hare-lip,  distortions,  moles,  marks,  &c,  have  been  traced  by  the 
mother  to  such  passions  in  far  too  many  instances  to  render  us  in  the  least 
sceptical  upon  that  point.  Now,  in  this  particular  instance,  some  of  the  parts 
or  divisions  of  the  mother's  Brain  must  act  in  association  or  simultaneously, 
while  others  act  independently  or  in  alternation  ;  for  otherwise  you  could  not 
understand  how  the  Brain  of  the  mother  should  influence  the  growth  of  the 
child  in  vtero,  and  at  the  same  time  continue  to  play  its  part  in  the  parental 
economy.  Some  of  its  various  portions  must  act  in  these  respects  alternately, 
for  they  cannot  do  both  at  one  and  the  same  moment  of  time.  But,  here 
again,  as  in  other  instances,  a  want  of  harmony  may  arise — the  Brain  may 
continue  to  exercise  its  influence  over  the  child  too  long ;  in  other  cases  it 
may  forget  the  child  for  the  mother.  How  such  want  of  harmony  affects  the 
child,  we  can  onty  guess  from  analogy.  How  a  too  long  cerebral  neglect  of 
the  mother's  economy  may  influence  her,  we  daily  see  in  the  numerous  dis- 
orders to  which  she  is  then  liable — more  particularly  in  the  periodic  vomit- 
ings, and  also  in  the  swoon  or  faint  which  occasionally  comes  on  during  the 
pregnant  state.  Are  not  these  the  very  symptoms  that  happen  in  the  case 
of  a  person  who  has  had  a  blow  on  the  head,  or  who  has  been  much  bled  ? 
It  appears  to  me  probable  that  the  infant's  growth  must  take  place  principal- 
ly during  the  period  of  maternal  sleep  ;  for  it  is  chiefly  in  the  morning,  just 
as  she  awakes,  that  the  mother  experiences  those  vomitings  and  other  tymp- 
toms,  from  which  I  infer  the  Brain  has  been  too  long  neglecting  her  own 
economy.  But  even  as  a  natural  consequence  of  the  more  favourable  alter- 
nations of  cerebral  movement  which  take  place  during  pregnancy,  the  mother 
for  the  most  part  experiences  Chills,  Heats,  and  Sweats, — she  has  symp- 
toms, or  shades  of  symptom  at  least,  of  the  same.disorders  that  may  arise 
from  any  other  agency  affecting  the  Brain  in  a  novel  or  unusual  manner — she 
becomes  at  certain  times  pale  and  flushed  alternately,  and.  as  in  the  ease  of 
other  Fevers,  frequently  complains  of  headache.  When  blood-letting — the 
usual  refuge  of  the  ignorant — is  in  Buch  eases  tried,  the  blood  drawn  exhibits 
the  same  identical  e.rust,  which,  older  tin'  name  (if"  l»u  fly-coat,"  "  inflamed 
crust,"  &c,  so  manv  practitioners  have  delighted  to  enlarge  upon  as  the 
great  peculiarity  of  "  true  inflammatory  fever  !" 


LECTURE  VII.  153 

Pregnancy  has  been  defined  by  some  very  great  doctors,  to  be  a  "  natural 
process."  Now,  that  certainly  is  a  very  great  discovery  ;  but  they  mignt 
have  made  the  same  discovery  in  the  case  of  Disease  and  Death.  Is  not 
every  thing  in  Nature  a  natural  process,  from  the  fall  of  an  apple  to  the  com- 
position of  the  Iliad  ?  Every  thing  that  the  eye  can  see  or  the  ear  can  hear, 
is  natural ;  miracles  only  are  miraculous  ;  for  they  are  events  that  are  con- 
trary to  the  natural  order  of  things.  Pregnancy,  then,  is  a  natural  pro- 
cess ;  but  is  it  on  that  account  the  less  surely  a  febrile  state  ?  Is  it  for 
that  reason  the  less  certainly  an  Intermittent  Fever  ?  What  disorders  have 
not  originated  in  Pregnancy  ?  What,  in  cases  where  they  previously  exist- 
ed, has  it  not,  like  every  other  Fever,  cured  ?  If  it  has  produced  Epilepsv, 
Apoplexy,  Toothache,  Consumption,  Palsy,  Mania, — each  and  every  one  "of 
these  diseases  have  I  known  it  to  ameliorate,  suspend,  or  cure  !  I  remember 
„he  case  of  a  lady  who,  before  her  marriage,  squinted  to  perfection.  But 
when  she  became  pregnant  her  squint  diminished,  and  long  before  the  period 
of  her  confinement  it  was  cured  ;  never  did  I  see  such  an  improvement  in 
the  face  of  any  person.  Still,  if  Pregnancy  has  cured  squint,  I  have  known 
cases  where  it  produced  it.  How  completely,  then,  does  this  harmonise  with 
the  Unity  which  pervades  Disease  generally  ! 

Parturition, 

I  have  already  said,  is  a  series  of  pains  and  remissions,  but  it  is  not  an  inter- 
mittent fever ;  nor,  indeed,  has  it  any  resemblance  to  that  affection !  So,  at 
least,  I  have  been  assured  by  very  clever  doctors :  and  they  have  told  me 
the  same  of  pregnancy !  Is  this  question,  then,  completely  settled  in  the 
negative  ?  Certainly  ;  it  is  settled  to  the  satisfaction  of  all  who  pin  their 
faith  upon  mere  human  authority.  But  human  authority  seldom  settled  any 
thing  with  me  ;  for  wherever  I  have  had  an  interest  in  knowing  the  truth,  I 
have  generally  appealed  from  the  decree  of  that  unsatisfactory  court  to  the 
lefs  fallible  decision  of  the  court  of  fact.  And  what  does  fact  say  in  this  in- 
stance ?  Fact  says  that  child-labour,  in  almost  every  case,  commences  with 
chills  and  heats,  and  that  these  are  again  and  again  repeated  with  longer  or 
shorter  periods  of  immunity  during  its  progress.  But  how  do  I  know  all  this  ? 
you  will  ask — J  who  hold  modern  midwifery  in  horror  !  I  will  tell  you  truly 
— I  first  guessed  it ;  for  I  could  not  suppose  that  parturition,  unlike  every 
other  great  revolution  of  the  body,  could  be  either  apain-less  or  an  unperilous 
state  ;  or  that  it  could  be  free  from  the  chills,  heats,  and  remissions,  which  1 
had  always  observed  in  cases  of  that  character.  Still,  not  being  a  person 
easily  satisfied  with  guess-work,  I  took  the  trouble,  in  this  particular  instance, 
to  interrogate  nature.  And  as  sure  as  the  sun  ever  shone  on  this  earth,  na- 
ture completely  verified  the  fact  of  my  anticipation,  that  parturition,  in  every 
instance,  is  an  intermittent  fever.  In  some  of  my  medical  books,  too,  I  found 
shiverings  among  the  numerous  other  symptoms  mentioned  as  incidental  to 
women  at  this  period.  "  Sometimes,"  says  Dr.  Ramsbotham,  himself  a  man- 
midwife,  "  they  are  sufficiently  intense  to  shake  the  bed  on  which  the  patient 
lies,  and  cause  the  teeth  to  chatter  a3  if  she  were  in  the  cold  stage  of  an  ague- 
fit  ;  and  although  she  complains  of  feeling  cold,  the  surface  may  be  warm, 
and  perhaps  warmer  than  natural."  Now,  this  cold  sensation,  as  you  well 
know,  is  often  complained  of  by  ague  patients,  even  in  the  hot  stage.  In  spite 
of  every  assertion  to  the  contrary,  then  ;  in  spite  of  every  declaration  on  the 
part  of  medical  or  other  persons,  pregnancy  and  parturition  are  agues;  agues 
in  every  sense  of  the  word  ;  for  not  only  do  their  revolutions  take  place  in 
the  same  manner  as  those  of  ague,  but,  like  ague,  both  may  be  influenced  by 
medicines,  as  well  as  by  mental  impressions.  Indeed,  in  most  cases  of  par- 
turition, the  labour-^,  mark  the  word !  will  stop  in  a  moment  from  the  new 
cerebral  movement  induced  by  fright  or  surprise.  In  some,  the  fit  never 
returns,  and  the  most  terrible  consequences  ensue.     When  the  foetus  is  fairly 


154  LECTURE  VII. 

developed  in  the  tase  of  pregnancy,  and  the  labour  completed  in  that  of  par- 
turition, health  is  the  general  result ;  but  in  the  course  of  both,  as  in  the  course 
of  other  fevers,  every  kind  of  disease  may  show  itself,  and,  when  developed, 
may  even  proceed  to  mortality.     An  occasional  termination  of  pregnancy  is 

Abortion  or  Miscarriage  ; 

and  this,  in  every  case,  is  preceded  by  the  same  constitutional  symptoms  as 
pregnancy  and  parturition,  namely,  the  symptoms  or  shades  of  symptom  of 
ague.  Moreover,  when  a  woman  gets  into  a  habit  of  miscarrying,  such  mis- 
carriage, like  an  ague,  recurs  periodically,  and  takes  place  almost  to  a  day  at 
the  same  month  as  the  first.  A  lady  who  had  been  married  several  years, 
but  who  had  never  borne  a  living  child,  although  she  had  had  frequent  abor- 
tions, consulted  me  upon  the  subject.  Her  miscarriages  having  always  taken 
flace  at  the  same  period  of  pregnancy — about  the  end  of  the  third  month — 
desired  her  when  she  should  again  become  pregnant,  to  let  me  hear  from 
her  within  a  fortnight  of  the  time  she  might  expect  to  miscarry.  She  did  so, 
telling  me  at  the  same  time  she  knew  she  should  soon  be  taken  ill,  as  she  had 
already  had  shiverings.  I  directed  her  to  use  an  opium  suppository  nightly, 
which  she  did  for  a  month,  and  she  was  thus  enabled  to  carry  her  child  to  the 
full  time.  She  had  two  children  since,  and  all  three  are  well  and  thriving. 
I  have  succeeded  in  similar  cases  with  the  internal  exhibition  of  quinine,  iron, 
hydrocyanic  acid,  &c.  But  opium,  where  the  drug  does  not  decidedly  dis- 
agree, will  be  found  the  most  generally  useful  of  our  medicines  in  checking 
the  habit  of  miscarriage.  Need  I  tell  you,  that  in  no  case  should  it  be  con- 
tinued where  it  excites  vomiting. 

The  tendency  to  return  of  any  action  which  has  once  taken  place  in  the 
constitution,  is  a  law  even  in  some  effects  of  accidents.  A  lady  who,  from 
fright  during  a  storm,  miscarried  of  her  first  child,  a  boy,  never  afterwards, 
when  pregnant  with  boys,  could  carry  them  beyond  the  time  at  which  she 
miscarried  of  the  first.  On  the  other  hand,  she  has  done  well  with  every  ofle 
of  her  daughters,  five  in  number,  all  of  whom  grew  to  womanhood. 

To  mothers  and  nurses,  next  to  pregnancy  and  parturition,  there  is  no  sub- 
ject so  interesting  as 

Teething. 

By  both,  the  birth  of  the  first  tooth,  like  the  birth  of  a  first  child,  is  com- 
monly expected  with  a  certain  degree  of  anxiety,  if  not  of  fear.  Why  is  this  ? 
Why,  but  because,  as  in  the  case  of  pregnancy,  before  the  dormant  germ  can 
be  called  into  action — before  the  embryo  tooth  can  be  developed — there  must 
be  a  complete  corporeal  revolution,  an  intermittent  fever  of  more  or  less 
intensity,  varying  according  to  the  varying  conditions  of  particular  constitu- 
tions ?  '  And  what  a  curious  unity  runs  through  all  creation,  producing  those 
wonderful  analogies  that  alone  can  lead  us  to  the  proper  study  of  nature  ! — 
The  embryo  tooth,  like  the  embryo  infant,  is  the  offspring  of  a  womb — tiny 
indeed,  but  still  rightly  enough  termed  by  the  profession  matrix,  that  being 
only  another  Latin  word  for  uterus  or  womb.  Both,  also,  are  ushered  into 
the  world  by  fever.  The  more  healthy  and  vigorous  the  child,  the  more  sub- 
dued will  the  teething  fever  for  the  most  part  be,  and  the  teething  itself  will 
consequently  be  less  painfully  accomplished;  just  as  under  the  same  circum- 
stances the  parturient  mother  will  more  surely  bring  forth  her  young  in  safety. 
In  those  cases,  on  the  contrary,  where  the  child  is  weakly  or  out  of  health, 
the  fever  will  be  proportionally  severe.  The  generality  of  teething  children, 
after  having  been  comparatively  well  during  the  day,  become  feverish  at  a 
particular  hour  in  the  night.  Now,  the  newly  developed  tooth,  though  in  the 
first  instance  itself  a  mere  effect  of  the  fever,  very  soon  contributes,  by 
the  painful  tension  which  its  increasing  growth  produces  in  the  gum,  to  ag- 
gravate and  prolong  the  constitutional  disorder.     It  is  first  an  eject,  and  then 


LECTURE  VII.  155 

a  superadded  cause  or  aggravant.  Gentlemen,  in  this  fever,  we  have  a  fresh 
illustration  of  the  unity  of  disease  ;  a  fresh  proof  that  intermittent  fever,  in 
some  of  its  many  shades,  is  the  constitutional  revolution  which  ushers  in  every 
kind  of  corporeal  disorder.  How  many  varieties  of  local  disease  may  be  pro- 
duced during  the  intermittent  fever  of  teething  !  Every  spasmodic  and  para- 
lytic distemper  you  can  name  ;  convulsion,  apoplexy,  lock-jaw,  sr|uir.t,  curved 
spine,  with  all  the  family  of  structural  disorders,  from  cutaneous  rash  and 
eruption  to  mesenteric  disorganisation  and  dysentery.  Should  the  gum  be 
lanced  in  these  cases  ?  Who  can  doubt  it  ?  If  you  found  the  painful  tension 
produced  by  the  matter  of  an  abscess  keeping  up  a  great  constitutional  dis- 
order, would  you  not  be  justified  in  letting  out  the  matter  with  a  lancet  ? 

The  cases  are  similar.  In  many  instances  of  teething,  then,  the  gum-lancet 
may  be  used  with  very  great  advantage ;  but  with  greater  advantage  still 
may  you  direct  your  attention  to  the  temperature  of  the  child's  body. 
When  that  is  hot  and  burning,  when  its  little  head  feels  like  fire  to  your 
hand,  pour  cold  water  over  it,  and  when  you  have  sufficiently  cooled  it 
throughout,  it  will  in  most  cases  go  to  sleep  in  its  nurse's  arms.  During 
the  chill-Rt,  on  the  contrary,  you  may  give  it  an  occasional  tea-spoonful  of 
weak  brandy  and  water,  with  a  little  dill  or  aniseed  to  comfort  and  warm  it ; 
having  recourse  also  to  friction  with  hot  flannel,  or  to  the  warm  bath.  Dur- 
ing the  period  of  remission,  the  exhibition  of  small  doses  of  calomel,  quinine, 
or  opium,  with  prussic  acid  occasionally,  will  often  anticipate  the  subsequent 
fits,  or  render  them  trifling  in  comparison  with  those  that  preceded  them. 

But,  Gentlemen,  I  should  explain  to  you  that  you  may  sometimes  be  met 
with  considerable  opposition  on  the  part  of  the  wiseacres  of  the  profession, 
when  you  propose  Quinine  or  Prussic  Acid  in  infantile  disease, — in  the  cases 
of  infants  suffering  from  convulsions  and  flatulence.  You  remember  what  I 
told  you  of  this  disease — that  infantile  convulsion  depends  in  every  instance 
upon  cerebral  exhaustion.  It  is  often  the  effect  of  cold,  and  frequently  fol- 
lows upon  a  purge ;  I  have  known  the  disease  come  on  after  the  application 
of  a  leech.  "  No  fact,"  says  Dr.  Trotter,  "  is  better  known  to  the  medical 
observer,  than  that  frequent  convulsions  are  a  common  consequence  of  the 
large  loss  of  blood."  And  you  may  recollect  that  in  the  experiment  of  the 
animal  bled  to  death  by  Dr.  Seeds,  flatulence  and  convulsions  were  among 
the  symptoms  produced  by  the  evacuation.  Some  years  ago,  I  was  requested 
to  visit  a  child  affected  with  convulsions ;  before  I  saw  it,  the  poor  little 
thing  had  been  the  subject  of  thirteen  distinct  fits,  with  an  interval  of  remis- 
sion of  longer  or  shorter  duration  between  each.  What  do  you  think  was 
the  treatment  to  which  this  infant  had  been  in  the  first  instance  subjected  by 
the  practitioner,  then  and  previously  in  attendance  ?  Though  its  age  was 
under  six  months,  and  the  disease  clearly  and  obviously  remittent,  he  had 
ordered  it  to  be  cupped  behind  the  ear, — afraid,  as  he  explained  to  me,  of 
the  old  mechanical  bugbear,  pressure  on  the  brain.  How  compatible  this 
doctrine,  permanency  of  cause,  with  remission  of  symptom  !  The  quantity  of 
blood  taken  was  about  an  ounce,  but  the  convulsions  recurred  as  before. 
This  was  the  reason  why  I  was  called  in.  The  child  at  that  particular  mo- 
ment had  no  fit — so  after  taking  the  trouble  to  explain  the  nature  of  the  symp- 
toms to  the  attending  Sangrado,  I  suggested  Quinine  as  a  possible  preventive. 
The  man  of  cups  and  lancets  started,  but  acceded.  The  quinine,  however, 
upon  trial,  proving  abortive  in  this  instance,  I  changed  it,  according  to  my 
custom,  for  prussic  acid — after  taking  which,  the  infant  was  free  from  fits  for 
a  period  of  at  least  five  or  six  weeks, — when  the  convulsive  paroxysm  re- 
curred— from  what  cause,  I  know  not,  unless  it  might  be  from  a  Purge 
which  its  mother  injudiciously  gave  it  on  the  morning  of  recurrence.  The 
flatulence,  too,  with  which  the  child  was  all  along  troubled,  began  to  dimin- 
ish from  the  moment  it  took  the  prussic  acid.  You  may  perhaps  ask  me  in 
what  dose  I  prescribed  the  acid  here.  I  ordered  one  drop  to  be  mixed  with 
three  ounces  of  cinnamon  water,  and  a  tea-spoonful  of  the  mixture  to  be  given 


156  LECTURE  VII. 

every  two  hours  all  that  day — so  that  there  is  no  earthly  agent,  however 
powerful,  even  in  a  small  quantity,  that  may  not,  by  farther  diminution,  be 
adapted  to  any  state  and  strength — to  any  age  or  condition  of  life  for  which 
you  may  be  desirous  of  prescribing  it.  In  this  respect,  medicine  resembles 
every  thing  in  nature.  In  the  case  of  oolors,  for  example, — the  most  intense 
blue  and  the  deepest  crimson,  by  the  art  of  the  painter,  may  each  be  so 
managed  that  the  eye  shall  not  detect,  in  his  design,  a  trace  of  either  one  or 
the  other.  In  the  case  of  the  infant  just  mentioned,  the  dose  of  prussic  acid 
was  about  the  twenty-fourth  part  of  a  drop,  and  its  good  effects  were  very 
immediate  and  very  obvious.  Nevertheless,  when  the  attending  practitioner 
came  in  the  morning  to  see  the  little  patient,  then  completely  out  of  danger, 
he  was  so  horrified  by  the  medicine  which  had  produced  the  improvement, 
that  he  stated  to  the  family  he  could  not,  in  conscience,  attend  with  me  any 
longer.  He  accordingly  took  his  leave  of  the  child  he  himself  had  breught 
into  the  world,  and  all  because  he — a  man-midwife  ! — could  not  approve  of 
the  treatment  that  saved  its  fife.  Yet  this  very  person,  without  hesitation, 
let  loose  all  at  once  the  Eight  lancets  of  the  cupping  instrument  on  the  head 
of  the  same  infant,  whose  age,  be  it  remembered,  was  under  six  months ! 
Gentlemen,  though  I  will  not  condescend  to  name  the  individual  who,  having 
so  heroically,  in  this  instance,  swallowed  the  camel,  found  such  a  difficulty 
afterwards  in  approaching  the  gnat,  I  may  state  for  your  diversion  that  he  is 
a  very  great  little  man  in  his  way — being  no  less  than  one  of  Her  Majesty's 
principal  accoucheurs — a  proof  to  you  that  "  Court-fools"  are  as  common  as 
ever.  Indeed,  the  only  difference  I  see  in  the  matter  is  this — that  whereas 
in  the  olden  times  such  personages  only  exhibited  in  cap  and  bells  at  the 
feast  and  the  revel,  they  now  appear  in  a  less  obtrusive  disguise,  and  act  still 
more  ridiculous  parts  on  the  gravest  occasions. 

One  very  great  obstacle  to  improvement  in  medicine  has  been  the  very 
general  preference  given  by  Englishwomen  to  male  over  female  practitioners 
of  midwifery  ;  for  by  means  of  that  introduction,  numbers  of  badly-educated 
persons  not  only  contrive  to  worm  themselves  into  the  confidence  of  families, 
but  by  the  vile  arts  to  which  they  stoop,  and  the  collusions  and  conspiracies 
into  which  they  enter  with  nurses  and  each  other,  they  have  in  a  great  mea- 
sure managed  to  monopolise  the  entire  practice  of  physic  in  this  country. 
To  check  the  career  of  these  people,  Sir  Anthony  Carlisle  wrote  his  famous 
letter  to  the  Times  newspaper,  wherein  he  declared  that  "  the  birth  of  a 
child  was  a  natural  process,  and  not  a  surgical  operation."  Notwithstanding 
the  howl  and  the  scowl  with  which  that  letter  was  received  by  the  apothe- 
caries, it  is  pleasing  to  see  that  the  public  are  now  beginning  to  be  aware  of 
the  fact  that  more  children  perish  by  the  meddlesome  interference  of  these 
persons,  than  have  ever  been  saved  by  the  aid  of  their  instruments.  How 
many  perish  by  unnecessary  medicine,  common  sense  may  form  some  notion 
— for  the  fashion  of  the  day  is  to  commence  with  physic  the  moment  the 
child  leaves  the  womb — to  dose  every  new-born  babe  with  castor  oil  before 
it  has  learnt  to  apply  its  lip  to  the  nipple  !  Who  but  an  apothecary  could 
have  suggested  such  a  custom  ?  Who  but  a  creature  with  the  mind  of  a 
mechanic  and  the  habits  of  a  butcher,  would  think  of  applying  a  cupping  in- 
strument behind  an  infant's  ear  to  stop  wind  and  convulsions  ?  The  nurses 
and  midwives  of  the  last  age  knew  better.  Their  custom  in  such  cases  was 
to  place  a  laurel-\e&(  upon  the  tongue  of  the  child.  The  routinists  laughed 
at  what  they  called  a  mere  old  woman's  remedy,  and  declared  that  it  could 
have  no  effect  whatever ;  they  little  knew  that  its  strong  odor  and  bitter 
taste  depended  upon  the  prussic  acid  it  contained  !  Gentlemen,  you  mav  get 
many  an  excellent  hint  from  every  description  of  old  women  but  tho  old  wo- 
men of  the  profession — the  pedantic  doctors,  who  first  laugh  at  the  laurel-leaf 
as  inert,  and  yet  start  at  the  very  medicine  upon  which  its  virtues  depend, 
when  given  with  the  most  perfect  precision  in  the  measured  form  of  prussic 
acid ,'  men  who,  in  the  same  mad  spirit  of  inconsistency,  affect  to  be  horrified 


LECTURE  VIII.  157 

at  the  mention  of  opium  or  arsenic,  while  they  dose  you  to  death  with  pur- 
gative physic,  or  pour  out  the  blood  of  your  life  as  if  it  were  so  much  ditch- 
water  ! 

Gentlemen,  there  is  such  a  thing  as 

Hereditary  Periodicity. 

If  you  take  a  particular  family,  and,  as  far  as  practicable,  endeavor  to  trace 
their  diseases  from  generation  to  generation,  you  will  find  that  the  greater 
number  die  of  a  particular  disease.  Suppose  this  to  be  pulmonary  consump- 
tion. Like  the  ague,  which  makes  its  individual  revisitations  only  on  given 
days,  you  shall  find  this  disease  attacking  some  families  only  in  given  gener- 
ations— affecting  every  second  generation  in  one  case  ;  every  third  or  fourth 
in  another.  In  some  families  it  confines  itself  to  a  given  sex,  while  in  the 
greater  number,  the  age  at  which  they  become  its  victims  is  equally  determi- 
nate— in  one  this  disease  appearing  only  during  childhood,  in  another  restrict- 
ing itself  to  adult  life  or  old  age.  By  diligently  watching  the  diseases  of 
particular  families,  end  the  ages  at  which  they  respectively  reappear,  and  by 
directing  attention  in  the  earliest  stages  of  constitutional  disorder  to  those 
means  of  prevention  which  I  have  in  the  course  of  these  lectures  so  frequent- 
ly had  occasion  to  point  out  to  you,  much  might  be  done  to  render  the  more 
formidable  class  of  disorders  of  less  frequent  occurrence — mania,  asthma, 
epilepsy,  and  consumption  might  thus,  to  a  certain  extent,  be  made  to  disap- 
pear in  families  where  they  had  been  for  ages  hereditary.  But  alas  !  then, 
for  the  medical  profession,  the  members  of  which  might  in  that  case  exclaim, 
"  Othello's  occupation's  gone  !" 


LECTURE  VIII. 

the  senses — animal  magnetism — the  passions — baths — exercise— 
homceopathy. 
Gentlemen, 

The  Causes  of  Disease,  we  have  seen,  can  only  affect  the 
Dody  through  one  or  more  of  the  various  modifications  of  nervous  perception. 
No  disease  can  arise  independent  of  this — no  disease  can  be  cured  without  it. 
"Who  ever  heard  of  a  corpse  taking  the  Small-pox  ?  or  of  a  tumour  or  a  sore 
being  healed  in  a  dead  body  ?  A  dreamer  or  a  German  novelist  might  imagine 
such  things.  Even  in  the  living  subject,  when  nerves  have  been  accidentally 
paralysed,  the  most  potent  agents  have  not  their  influence  over  the  parts 
which  such  nerves  supply.  If  you  divide  the  pneumo- gastric  nerves  of  a 
living  dog — nerves  which,  as  their  name  imports,  connect  the  Brain  with 
the  Lungs  and  Stomach — arsenic  will  not  produce  its  accustomed  effect  on 
either  of  these  organs.  Is  not  this  one  of  many  proofs  that  an  external  agent 
can  only  influence  internal  parts  banefully,  at  least,  by  means  of  its  Elec- 
tric power  over  the  nerves  leading  to  them  ?  Through  the  same  medium, 
and  in  the  same  manner,  do  the  greater  number  of  our  Remedial  Forces  exert 
their  salutary  influence  on  the  human  frame.  But  whether  applied  for 
good  or  for  evil,  all  the  forces  of  nature  act  simply  by  Attraction  or  Repulsion. 
The  Brain  and  Spinal  Column — the  latter  a  prolongation  of  the  former— are 
the  grand  centres  upon  which  every  medicine  sooner  or  later  tells,  and 
many  are  the  avenues  by  which  these  centres  may  be  approached.  Through 
each  of 

The  Five  Senses, 

the  Brain  may  be  either  beneficially  or  banefully  influenced.     Take  away 
these,  and  where  would  be  the  joys,  sorrows,  or  the  diseases  of  mankind  1 


158  LECTURE  VIII. 

We  shall  first  speak  of  Sight.  The  view  of  a  varied  and  pleasant  coun- 
try may,  of  itself,  improve  the  condition  of  ninny  '.n  .rands — while  a  gloomy 
situation  has  too  often  had  the  reverse  effect.  iVrc  are  cases,  nevertheless, 
in  which  pleasant  objects  only  pain  and  disE'd.'-c  che  patient  by  their  multi- 

J)licity  or  brightness.     Night  and  -'darkness,  '.n  such  circumstances,  have  af- 
brded  both  mental  and  bodily  tranquillity.     Thi 


he  presence  of  a  strong  light 
affects  certain  people  with  headache  ;  ard  th»re  are  persons  to  whom  the 
first  burst  of  sunshine  is  troublesome,  on  account  of  the  fit  of  sneezing  it  ex- 
cites. A  flash  of  lightning  has  caused  and  cured  the  palsy.  Laennec  men- 
tions the  case  of  a  gentleman  who,  when  pursuing  a  journey  on  horseback, 
suddenly  arrived  at  an  extensive  plain.  The  view  of  this  apparently  inter- 
minable waste  affected  him  with  such  a  sense  of  suffocation,  that  he  was 
forced  to  turn  back.  Finding  himself  relieved,  he  again  attempted  to  proceed  ; 
but  the  return  of  the  suffocative  feeling  forced  him  to  abandon  his  journey. 
The  common  effects  of  gazing  from  a  great  height  are  giddiness,  dimness  of 
sight,  with  a  sense  of  sickness  and  terror;  yet  there  are  individuals  who  ex- 
perience a  gloomy  joy  upon  such  occasions ;  and  some  become  seized  with  a 
feeling  like  what  we  suppose  inspiration  to  be — a  prophetic  feeling,  that  leads 
them  to  the  utterance  an.l  prediction  of  extravagant  and  impossible  things. 
Others  again,  under  such  circumstances,  have  an  involuntary  disposition  to  hurl 
themselves  from  the  precipice  upon  which  they  stand.  Sir  Walter  Scott,  in  his 
Count  Robert  of  Paris,  makes  Ursel  say,  "  Guard  me,  then,  from  myself,  and 
save  me  from  the  reeling  and  insane  desire  which  I  feel  to  plunge  myself  in  the 
abyss,  to  the  edge  of  which  you  have  guided  me."  Any  kind  of  motion  upon 
the  body  may  affect  the  Brain  for  good  or  for  evil ;  and  through  the  medium 
of  the  Eye  novel  motion  acts  upon  it  sometimes  very  curiously.  Who  of  you 
has  not  experienced  giddiness  from  a  few  rapid  gyrations  ?  Everything  in 
the  room  then  appears  to  the  eye  to  turn  round.  If  for  a  length  of  time  you 
look  from  the  window  of  a  coach  in  rapid  motion,  you  will  become  dizzy  ;  the 
same  thing  produces  sickness  with  some.  Many  people  become  giddy,  and 
even  epileptic,  from  looking  for  a  length  of  time  on  a  running  stream  ;  with 
others,  this  very  strea?n-ga.zing  induces  a  pleasurable  reverie,  or  a  disposition 
to  sleep.  Apply  these  facts  to  Animal  Magnetism* — compare  them  with  the 
effects  of  the  manipulations  so  called,  and  you  will  have  little  difficulty  in 
arriving  at  a  just  estimate  of  their  nature  and  mode  of  action.  What  is  animal 
magnetism?  It  consists  in  passing  the  hands  up  and  down  before  the  eyes 
of  another  slowly,  and  with  a  certain  air  of  pomp  and  mystery  ;  now  moving 
them  this  way,  now  that.     You  must,  of  course,  assume  a  very  imperturba- 

*  [Three  years  ago,  viz.,  iu  184c£  when  I  published  my  first  American  edition  of 
this  work,  I  was  almost  as  scepricar  on  this  subject  as  Dr.  Dickson.  But  my  scep- 
ticism has  been  much  shaken  since,  and  I  am  constrained  to  think  with  Hamlet, 
that,  "  there  aro  more  things  in  heaven  and  earth  than  are  dreamt  of  in  our  phi- 
losophy." Nor  would  it  be  a  sound  philosopical  objection  to  say  that  it  is  liable  to 
be  abused ;  since  that  is  the  lot  of  every  gift  of  Providence — to  quote  again  a  pas- 
sage from  Shakspeare,  that  accurate  observer : — 

"  Naught  so  vile  that  on  the  earth  doth  live, 
But  to  the  earth  some  special  good  doth  give  ; 
Nor  aught  so  good,  but.  strained  from  that  fair  u#e, 
Revolts  from  true  birth,  stumbling  on  abuie ! 

Our  author  admits,  which  indeed  can  hardly  be  denied,  that  the  action  of  medi- 
cines, both  of  the  mineral  and  the  vegetable  kingdoms,  is  electric,  or,  what  is  the 
same  thing,  magnetic.  Why  should  we  infer  the  higher  kingdom,  the  animal,  t.> 
be  deficient  in,  instead  of  possessing  in  a  higher  degree,  .1  power  90  subtle  and  so 
important?  May  it  notyet  be  demonstrated  that  the  two  forma  of  electricity,  now 
known  as  the  positivo  and  the  negative,  are  simply,  the  one,  the  motion  of  the  par- 
ticles of  the  light  of  the  sun,  the  oilier,  the  motion  rafthe  particles  of  his  heal — both 
together,  with  their  varieties  of  intercourse,  constituting  the  all  of  mineral  and  vege- 
table power,  and  the  all  of  physical  life,  and  their  disturbance  or  imperii  cl  adjust- 
ment iu  the  human  body,  the  all  of  physical  disease,  or  ditordi  r  f     W.  T.  ] 


LECTURE  VIII.  159 

ble  gravity,  and  keep  your  eye  firmly  fixed  upon  the  patient,  in  order  to 
maintain  your  mental  ascendancy.  On  no  account  must  you  allow  your  fea- 
tures to  relax  into  a  smile.  If  you  perform  your  tricks  slowly  and  silently 
in  a  dimly-lit  chamber,  you  will  be  sure  to  make  an  impression.  "What  im- 
pression ? — Oh  !  as  in  the  case  of  the  stream-g&zer,  one  person  will  become 
dreamy  and  entranced;  another,  sleepy;  a  third,  fidgetty,  or  convulsed. 
Who  are  the  persons  that,  for  the  most  part,  submit  themselves  to  this  mum- 
mery? Dyspeptic  men,  and  hysteric  women — weak,  curious,  credulous 
persons,  whom  you  may  move  at  any  time  by  a  straw  or  a  feather.  Hold 
up  your  finger  to  them,  and  they  will  laugh ;  depress  it,  and  they  will  cry  ! 
So  far  from  being  astonished  at  any  thing  I  hear  of  these  people,  I  only  won- 
der it  has  not  killed  some  of  them  outright — poor  fragile  things  !  A  few  years 
ago  I  took  it  into  my  head  to  try  this  kind  of  pawing  in  a  case  of  epilepsy. 
It  certainly  had  the  effect  of  keeping  off  the  fit ;  but  what  hocus-pocus  has 
not  done  that?  I  have  often  done  the  same  thing  with  a  stamp  of  my  foot. 
In  a  case  of  cancer  upon  which  I  tried  the  "  passes,"  as  these  manipulations 
are  called,  the  lady  got  so  fidgetty,  I  verily  believe,  if  I  had  continued  them 
longer,  she  would  have  become  hysterical  or  convulsed  !  That  effects  reme- 
dial and  the  reverse,  however,  may  be  obtained  from  them,  I  am  perfectly 
satisfied.  Nor  do  I  mean  to  deny  that  in  a  few — a  very  few  instances,  these, 
or  any  other  monotonous  motions,  may  produce  some  extraordinary  effects — 
effects  which,  however,  are  the  rare  exception  instead  of  the  general  rule. 
Whatever  any  other  cause  of  Disease  may  produce  on  the  human  body,  these 
manipulations  may  by  possibility  occasion — Somnambulism,  Catalepsy,  or 
what  you  please.  There  is  no  more  difficulty  in  believing  this  than  there  is 
difficulty  in  believing  that  the  odour  of  a  rose,  or  the  sight  of  a  cat,  will  make 
certain  people  swoon  away.  This  much,  then,  I  am  disposed  to  admit.  But 
when  the  animal  magnetisers  assert  that  the  senses  may  be  transposed, — 
that  the  stomach  may  take  the  office  of  the  eye*,  and  render  that  beautiful 
organ,  with  all  the  complete  but  complex  machinery  by  which  it  conveys 
light  and  shadow  to  the  Brain,  a  work  of  supererogation  on  the  part  of  the 
Creator,  I  turn  from  the  subject  with  feelings  of  invincible  disgust.  If  it  be 
objected  that  the  magnetisers  have  produced  persons  of  both  sexes  who  with 
their  eyes  closed  and  bandaged  read  a  book  placed  upon  their  stomach  by 
means  of  that  organ,  through  waistcoat,  boddice,  and  heaven  knows  what 
all ! — I  reply,  that  the  charlatans  of  all  countries  every  day  perform  their 
tricks  with  a  swiftness  that  altogether  eludes  the  unpractised  eye.  Thousands 
of  persons  have  seen  the  Indian  juggler  plant  a  mango-stone  in  the  ground, 
and  in  the  course  of  a  few  minutes  do  what  nature  can  only  do  in  the  course 
of  years,  make  it  successively  produce  a  plant  with  leaves,  blossoms,  and 
lastly,  fruit !  How  this  trick  is  done,  the  witnesses  who  describe  it  know  no 
more  than  you  or  I  do  how  the  magnetisers  perform  their  juggleries  ;  but  few 
who  have  seen  the  Indian  trick  believe  in  the  reality  of  any  one  of  the  vari- 
ous transformations  with  which  their  eyes  have  been  cheated.  Gentlemen, 
the  transposition  of  the  senses,  is  only  an  old  whimsey  newly  dressed  up  under 
the  name  of  "  clairvoyance."     We  read  in  Hudibras  of 


Roscrucian  virtuosis, 


Who  see  with  Ears  and  hear  with  Noses  ! 

The  greater  part  of  the  influence  of  external  impressions  upon  the  eye,  as 
upon  other  organs,  depends  upon  novelty  solely,  for  pomp  and  pageantry 
affect  the  actors  and  the  spectators  in  exactly  opposite  ways.  With  what 
different  feelings,  for  example,  the  courtier  approaches  his  sovereign,  from  a 
person  newly  "  presented  !"  The  one,  all  coolness,  looks  only  for  an  oppor- 
tunity of  improving  his  advantages  while  the  other's  only  care  is  not  to  make 
a  fool  of  himself.  How  different  the  effect  of  a  punishment  parade  upon  the 
raw  recruit  and  Jhe  old  soldier  !  In  a  regiment  of  veterans,  a  thousand  strong, 
you  will  not  find  a  man  move  from  his  place,  no,  nor  a  countenance  change 


160  LECTURE  VIII. 

its  cast  or  hue,  while  lash  follows  lash,  and  the  blood  flows  in  streams  from 
the  back  of  the  culprit.  The  same  scene  enacted  before  a  body  of  newly- 
enlisted  lads  of  equally  numerical  strength,  will  alter  the  expression  of  every 
face  ;  nay,  half-a-dozen  or  more  will  drop,  some  fainting,  some  vomiting,  some 
convulsed  and  epileptic.  A  medical  student  of  my  acquaintance,  the  first 
time  he  saw  an  amputation,  not  only  fainted,  but  lost  his  sight  for  nearly  half- 
an-hour ;  yet  the  same  student  afterwards  became  celebrated  for  his  manual 
dexterity,  and  the  coolness  and  steadiness  with  which  he  performed  his  am- 
putations. To  use  a  vulgar  phrase,  familiarity  breeds  contempt.  How- 
awkward  most  persons  feel  when,  for  the  first  time,  they  experience  a  ship's 
motion  at  sea  !  The  young  sailor,  like  the  young  surgeon,  soon  gets  cured 
of  his  squeamishness ;  for  the  disposition  to  be  sea-sick  vanishes  after  a  voyage 
or  two.  Now  all  this  ought  to  convince  you  of  the  necessity  of  changing 
your  remedies  in  disease  ;  for  what  will  produce  a  particular  effect  one  day 
will  not  always  do  it  another.  With  the  body,  as  with  the  mind,  novelty  and 
surprise  work  wonders. 

Do  you  require  to  be  told  that  you  can  influence  the  whole  corporeal  mo- 
tions through  the  organ  of  hearing?  I  have  stopped  the  commencing 
epileptic  fit  by  simply  vociferating  in  the  ear  of  the  patient.  The  atoms  of 
the  brain,  like  the  atoms  of  other  parts,  cannot  do  two  things  at  once ;  they 
cannot,  at  one  and  the  same  moment  of  time,  maintain  the  state  of  arrest  which 
constitutes  attention,  and  the  state  of  motion  on  which  the  epileptic  convul- 
sions depend.  Produce  cerebral  attention  in  any  way  you  please,  and  there 
can  be  no  epilepsy.  In  this  way,  a  word  may  be  as  efficacious  as  medicine. 
Certain  sounds,  on  the  contrary,  set  the  teeth  on  edge. 

The  influence  of  melody  upon  the  diseases  of  mankind  was  so  fully  be- 
lieved by  the  ancients,  that  they  made  Apollo  the  god  both  of  medicine  and 
music  ;  but  sweet  sounds,  like  the  other  sweets,  are  not  sweet  to  every  body. 
Nicano,  Hippocrates  tells  us,  swooned  at  the  sound  of  a  flute  ;  what  would 
he  have  done  had  he  been  obliged  to  sit  out  an  opera  ?  Many  people  are 
melancholy  when  they  hear  a  harp  ;  yet  the  melancholy  of  Saul  was 
assuaged  by  David's  harping.  Some  persons  become  frantic  when  a  fiddle 
plays, 

And  others  when  the  bagpipe  sings  i'  the  nose 

Cannot  contain  their  urine ;  for  affection, 

Mistress  of  passion,  sways  it  to  the  mood 

Of  what  it  likes  or  loathes. — Shakspeare. 

Every  body  has  heard  of  the  wonderful  effects  of  the  Ranz  des  Vaches,  that 
air  which,  according  to  circumstances,  may  either  rouse  the  Switzer  to  the 
combat,  or  stretch  him  hopeless  and  helpless  upon  the  sick  bed  from  which 
he  shall  rise  no  more.  Oh  !  these  national  airs  have  marvellous  effects  with 
many  people  !  I  have  known  them  produce  and  cure  almost  every  disease 
you  can  name ;  but  their  influence  in  this  case  greatly  depends  upon  associa- 
tion. Captain  Owen  had  more  faith  in  an  old  song  as  a  remedy  for  the  tro- 
pical fever,  from  which  his  crew  suffered,  than  in  all  the  physic  prescribed 
for  them  by  the  ship's  surgeon.  The  singing  of  a  long-remembered  stanza, 
he  assures  us,  would,  in  a  minute,  completely  change  for  the  better  the 
chances  of  the  most  desperate  cases.  Upon  what  apparently  trifling  things 
does  not  life  itself  often  turn  ! — 

It  may  be  a  sound, 

A  tone  of  music,  summer's  eve  or  spring — 

A  flower,  the  wind,  the  ocean,  which  shall  wound, 

Strikbg  the  electric  chain  with  which  we're  darkly  bound. — Byron. 

How  strangely  some  people  are  affected  by  SHELL  !     Who  that  had  never 

seen  or  experienced  it,  would  believe  that  the  odour  of  the  rose  could  produce 

ig?  or  that  the  heliotrope  and  the  tuberose  have  made  some  men  asth- 

matical  ?     There  are  persons  who  cannot  breathe  the  air  of%  room  containing 

ipecacuan,  without  suffering  from  asthma.     The  smell  of  musk,  so  grateful 


LECTURE  VIII.  161 

to  many  people,  sickens  some.  An  odour,  in  certain  cases,  may  be  as  good 
a  cordial  as  wine  ;  every  old  woman  knows  the  virtue  of  hartshorn  and  burnt 
feathers. 

I  am  almost  afraid  to  speak  of  taste,  for,  you  know,  de  gustibus  non  est 
disputanduni.  Might  not  the  Red  Indian,  when  taunted  for  devouring  vermin, 
retort  upon  the  "pale  face"  for  his  mite-eating  propensity?  The  Esqui- 
maux, who  rejects  sugar  with  disgust,  esteems  train-oil  a  luxury  ;  but  though 
he  prefers  a  tallow-candle  to  butter,  he  has  as  perfect  a  taste  for  whiskey  as 
any  Irishman  among  us  ;  that  is,  before  Father  Mathew  and  temperance  so- 
cieties became  the  rage.  How  you  would  stare  if  you  saw  a  man  in  his 
senses,  chewing  quick-lime !  yet  I  have  seen  some  hundreds  at  a  time  doing 
that.  I  allude  to  the  practice  of  the  Asiatics,  who  first  wrap  up  a  little  por- 
tion of  lime  in  a  betel-leaf,  and  chew  both,  as  our  sailors  do  tobacco.  Now, 
that  very  tobacco-chewing  has  always  seemed  to  me  an  odd  taste,  and  I  do 
not  wonder  that  others,  besides  fine  ladies,  have  sickened  at  the  sight  of  a 
quid.  Was  there  ever  such  a  fancy  as  that  of  the  Chinese,  who  eat  soup  made 
of  birds'  nests  ?  Morbid  in  the  first  instance,  such  tastes,  like  other  diseases, 
spread  by  imitation  or  contagion.  In  the  West  Indies,  the  negro  is  liable  to  a 
peculiar  fever,  called,  from  the  avidity  with  which  he  devours  clay,  Mai  d'Es- 
tomac.  His  whole  sensations,  during  this  fever,  are,  doubtless,  more  or  less 
deranged.  What  extraordinary  likings  and  longings  ladies  in  the  family  way 
occasionally  take  !  Some  will  eat  cinders,  some  have  a  fancy  for  rats  and 
mice,  and  some,  like  Frenchmen,  take  to  frog-eating  !  I  remember  reading 
of  a  lady  who  paid  fifty  pounds  for  a  bite  of  a  handsome  young  baker's 
shoulder  ;  the  same  lady  went  into  hysterics  because  the  poor  fellow  would 
not  permit  her  to  take  another  bite,  at  any  price.  If  you  smile  and  look  in- 
credulous at  this,  how  will  you  receive  what  I  am  going  to  tell  you  ?  While 
I  was  myself  studying  at  Paris,  some  twenty  years  ago,  a  woman  was  tried 
for  decapitating  a  child.  When  asked  her  motive  for  a  crime  so  horrible,  she 
replied,  "  Venvie  d'unefemme  grosse." 

Well,  now,  I  think  we  have  had  quite  enough  of  tastes.  We  shall,  there- 
fore, say  something  of  touch.  You  will  tell  me,  perhaps,  not  to  trouble  you 
on  that  subject ;  no  great  good  or  ill  can  happen  from  a  touch,  you  will  say. 
But  here  you  are  mistaken  :  many  curious  and  even  dangerous  affections  may 
originate  in  touch  simply,  provided  it  be  of  a  novel  or  unusual  kind.  Touch 
the  white  of  the  eye,  however  lightly,  with  your  finger,  or  a  feather,  and 
you  shall  have  pain  that  may  last  an  hour.  The  application  of  either  the  one 
or  the  other  to  the  throat  or  fauces  may  vomit  you  as  effectually  as  tartar 
emetic  or  ipecacuan  ;  every  nurse  knows  that.  A  bristle  introduced,  in  the 
softest  manner,  into  the  nose  or  ear,  has  thrown  some  people  into  fits.  Then 
what  extraordinary  effects  may  sometimes  follow  the  most  painless  touch  of 
the  bladder  by  a  catheter  or  a  bougie  !  I  do  not  know  what  other  medical 
men  have  seen,  but  I  have  over  and  over  again  witnessed  ague,  epilepsy, 
faint,  vomit,  and  diarrhoea,  all  from  the  mere  introduction  of  the  cathetre  or 
bougie  ;  and  I  have  even  traced  rheumatism  and  eruptions  to  the  same  ope- 
ration. You  all  know  the  effect  of  tickling.  Now,  what  is  tickling  but  a 
succession  of  short  touches  ?  And  see  how  wonderfully  it  affects  most  peo- 
ple !  you  may  drive  some  men  mad  by  it.  Though  it  has  been  carried  so 
far,  in  some  cases,  as  to  have  produced  convulsions,  and  even  death  itself, 
Mr.  Wardrop  actually  found  it  efficacious  in  some  convulsive  affections.  I 
have  already  given  you  instances  where  the  mere  application  of  a  ligature  to 
the  arm  or  leg  arrested  the  fit  of  mania,  epilepsy,  &c.  Now,  the  influence 
of  that  apparently  trifling  application  depends  upon  the  cerebral  attention 
which  it  excites  through  the  double  influence  of  sight  and  touch.  As  I 
hinted  to  you  before,  the  lancet  has  often  got  the  credit  for  the  good  effects 
produced  by  the  bandage.  Fear  of  the  operation  may  also,  on  some  occa- 
sions, have  aided  its  efficacy.  How  many  virtues  were,  at  one  time,  attri- 
buted to  a  king's  touch  ! — how  many  more  are  srill' believed  to  attach  to  the 


162  LECTURE  VIII. 

0 

touch  of  relics  ;  the  bones,  rags,  and  other  rattle-traps  of  saints  !  Priests  and 
princes,  you  have  by  turns  governed  mankind — justly  and  well,  sometimes — 
more  frequently  you  have  deluded  and  deceived  them.  If  the  credulity  and 
weakness  of  the  masses  have,  in  most  cases,  been  your  strength,  here  at  least 
the  dupe  has  not  always  been  a  loser  by  the  deceptions  you  practised.  The 
emotions  of  faith  and  hope,  which  your  mummery  inspired,  by  exciting  new 
revolutions  in  the  matter  of  the  brain,  have  assuredly  alleviated  and  even 
cured  the  sufferings  of  the  sick.  Strange  infatuation  of  mankind — with  whom, 
where  truth  fails,  imposture  may  succeed  !  In  what  docs  the  adult  differ 
from  the  infant — gullible  man,  who  gives  his  gold  for  an  echo,  from  the  child 
who  caresses  its  nurse,  when  telling  lies  to  please  it?  Ignorance  in  degree 
makes  the  only  difference.  Gentlemen,  let  us  now  inquire  into  the  manner 
in  which  the  human  frame  may  be  influenced  through  the  medium  of 

The  Passions. 

What  are  the  passions  ?  Grief,  Fear,  and  Joy — what  are  these  ? — Are 
they  entities  or  actions — the  workings  of  demons  within,  or  corporeal  varia- 
tions caused  by  impressions  from  without  ?  Have  not  the  Passions  all  some- 
thing in  common,  certain  features  or  shades  of  feature  so  precisely  the  same 
as  to  form  a  bond  of  unity  by  which  they  may  be  all  linked  together  ?  Are 
not  the  resemblances,  in  many  instances,  so  very  close  that  you  could  not;  tell 
one  from  another  ?  A  person  is  pale  in  the  face,  his  lip  quivers,  his  whole 
frame  trembles  or  becomes  convulsed.  Is  this  Fear,  Rage,  Love,  or  Hate  ? 
May  it  not  be  the  effect  of  a  change  of  temperature  simply  ?  Bailly,  when 
on  the  scaffold,  was  taunted  by  the  bystanders  for  trembling.  »«  Yes,"  he 
replied ;  "  but  it  is  with  Cold."  "  You  are  pale,  Sir,  your  Fear  betrays 
you."  "  If  I  am  pale,  it  is  with  Astonishment  at  being  accused  of  such  a 
crime  !"  "  You  blush,  Madam,  you  are  Ashamed  of  yourself."  "  Pardon  me, 
Sir,  it  is  your  Audacity  brings  the  redness  of  Rage  to  my  cheek."  You  see, 
then,  how  like  the  Passions  are  to  each  other,  and  how  difficult  it  is  to  guess 
at  the  causes  of  them  from  mere  appearance. 

Like  the  various  diseases  of  which  we  have  had  occasion  to  speak,  the 
Mental  Emotions, — or  rather  the  corporeal  actions  so  called — have  all  been 
associated  with  particular  organs  and  secretions.  Their  very  names  have 
changed  with  the  changes  in  medical  doctrine.  Who  among  you  would 
dream  of  placing  Grief  in  the  liver?  That  the  ancients  did  so,  is  evident  by 
the  name  they  gave  it — Melancholy  literally  signifies  "  black-bile."  Envy 
or  Spite  we  still  call  the  "  Spleen,"  and  when  a  person  is  enraced,  we  say 
"his  bile  is  up."  Europeans  place  Courage,  Benevolence,  and  Fear  in  the 
Heart, — the  Heart  which  has  enough  to  do  in  the  performance  of  its  own 
proper  office,  namely,  that  of  a  vessel  to  circulate  the  blood  through  El 
tem  ! — The  Persians  and  Arabs  associate  Fear,  Courage,  and  Benevolence 
with  the  liver  :  "  White-liver"  is  their  term  for  a  coward.  Shakspeare  uses 
the  word  'rTy-livered  in  the  same  sense. 

People  often  speak  of  "  Temperament,"  and  professors  of  philosophy  tell 
us  there  are  four  kinds.  If  a  man  is  hasty  or  violent,  his  temperament  is 
6aid  to  be  Choleric  or  bilious;  if  mentally  depressed,  Melancholic  or.  black- 
bilious  ;  if  of  a  joyful  and  happy  turn  of  mind,  he  is  of  a  Sanguineous  of  full- 
blooded  temperament ;  if  apathetic  or  listless,  the  temperament  is  Phlegma- 
tic— a  word  somewhat  difficult  to  translate,  inasmuch  as  it  originated  in  a 
fanciful  phantom,  which  the  ancients  believed  to  be  an  element  of  the  body! 
and  which  they  termed  "  phlegm.**'  Some  add  another  temperament,  which 
they  call  Leuco-phlegmatic,  or  white  phlegm!  I  wonder  they  never  took 
the  Saliva  to  distinguish  a  temperament;  surely  the  "  Salivom  tempera- 
ment" would  be  quite  as  rational  as  the  "Bilious."  What,  then,  are  all 
these  Temperaments — so  far,  at  least,  as  their  nomenclature  goee,  hut  pretty 
gibberish  ? — mere  sounds  invented  by  Pedantry  to  gull  Folly  ;  or,  in  the 
of  Horne  Tooke,  "  an  exemplar  <  auces, 


LECTURE  VIII.  163 

and  of  discoursing  deeply  and  learnedly  on  a  subject  with  which  we  are  per- 
fectly unacquainted  !"  It  never  occurred  to  the  sophists  of  the  schools  that 
man's  mental  dispositions,  like  his  corporeal  attributes,  are  every  day  altered 
by  time  and  circumstance.  Need  I  tell  you,  that  disease  has  made  the  brav- 
est man  quake  at  his  own  shadow,  and  turned  the  most  joyous  person  into 
a  moody  and  moping  wretch  ?  When  the  doctrines  of  the  Humoral  School 
prevailed,  the  word  Temperament  gave  way  to  humour,  and  good  and  bad 
humour  took  the  place  of  cheerful  and  sulky  temper.  We  are  in  the  daily 
habit  of  speaking  of  "the  spirits."  We  say  "low  spirits,"  and  "high 
spirits ;"  which  forms  of  expression  may  be  traced  to  the  period  when 
physicians  were  so  ignorant  as  to  suppose  that  the  arteries,  instead  of  carry- 
ing blood,  contained  air  or  "  spirits,"  from  Spiritus,  the  Latin  for  breath  or 
air.  That  was  the  reason  why  these  blood-vessels  were  first  called  aer-teries. 
This  confusion  which  pervades  all  language  has  materially  impeded  our  know- 
ledge both  of  the  physical  and  the  moral  man.  Locke  must  have  felt  this 
when  he  said,  "  Vague  and  insignificant  forms  of  speech,  and  abuse  of  lan- 
guage, have  so  long  passed  for  mysteries  of  science,  and  hard  or  misapplied 
words,  with  little  or  no  meaning;,  have,  by  prescription,  such  a  right  to  be 
mistaken  for  deep  learning  and  height  of  speculation,  that  it  will  not  be  easy 
to  persuade  either  those  who  speak  or  those  who  hear  them,  that  they  are  but 
the  covers  of  ignorance  and  hindrances  of  true  knowledge." 

"  We  cannot  entertain  a  doubt,"  says  Sir  H.  Davy,  "  but  that  every  change 
in  our  sensations  and  ideas  must  be  accompanied  with  some  corresponding 
change  in  the  organic  matter  of  the  body."  Through  the  medium  of  one  or 
more  of  the  five  senses  must  some  external  circumstance  first  operate  on  that 
part  of  it  called  the  Brain,  so  as  to  change  the  existing  relations  and  revo- 
lutions of  its  atoms,  before  there  can  be  what  we  term  a  Passion.  Whatever 
alters  the  cerebral  atoms  must  alter  the  actions  of  every  part  of  the  body — 
some  more,  some  less.  According  to  the  prominence  and  locality  of  one  set 
of  actions  or  another,  do  we,  for  the  most  part,  name  the  Passion.  The  jest 
that  will  make  one  man  laugh,  may  enrage  another.  What  are  the  features 
common  to  all  Passion  ? — Tremor,  change  of  temperature,  change  of  secre- 
tion. Do  not  these  constitute  an  Ague-fit  ?  Shakspeare,  with  his  accustom- 
ed penetration,  speaks  of  "  this  ague-fit  of  Fear,"  and  he  stretched  the 
analogy  even  to  the  world  around  him  : — 

"  Some  say  the  earth  was  fevered  and  did  shake." 

Hate,  Love,  and  Anger  are  equally  remarkable  for  their  ague-like  changes. 
You  remember  what  Hudibras  says  of  Love — that  it  is  only  an  "  ague-fit 
reversed."  The  same  may  be  said  of  Hope,  Joy,  and  Rage  ;  for  in  all  these 
Passions  the  "hot  fit  takes  the  patient  first."  Such  at  least  is  their  general 
effect ;  but  in  particular  instances,  as  in  the  real  Ague,  coldness  and  pallor 
usher  in  every  one  of  those  passionate  fits.  I  care  not  what  be  the  nature  of 
the  Passion — joy,  grief,  or  fear — the  constitutional  circle  of  actions  is  still  the 
same  ;  differing,  where  they  do  differ,  in  shade,  place,  and  prominence  sole- 
ly— but  in  no  greater  degree  than  one  Fever  differs  from  another.  Moreover, 
there  is  no  constitutional  affection  which  these  Passions  may  not  excite  or 
cure.  In  this  respect,  also,  they  resemble  the  Ague,  that  type  of  every  dis- 
turbed state,  whether  of  man  the  microcosm,  or  the  globe  he  inhabits.  We 
have  already,  to  a  certain  extent,  demonstrated  the  influence  of  particular 
Passions  in  the  production  of  certain  diseases.  We  have  further  proved  that 
the  same  morbid  actions  which  we  recognise  under  so  many  different  names, 
when  arising  from  a  blow  or  a  poison,  may  be  equally  the  result  of  a  mental 
impression  ;  we  have  established  their  absolute  identity  by  curing  them  with 
the  same  physical  agents.  The  history  of  medicine,  on  the  other  hand,  pre- 
sents us  with  innumerable  instances  of  the  beneficial  agency  of  these  very 
Passions  in  every  kind  of  disorder,  whatever  may  have  been  the  nature  of 
primary  cause.  Faith,  Confidence,  Enthusiasm,  Hope, — or  rather  the 
various  Causes  which  produce  them, — are  as  powerful  agents  in  the  cure  of 


164  LECTURE  VIII. 

the  sick  as  any  remedies  we  possess.  Not  only,  like  Bark,  or  Wine,  do  they 
often  give  rise  to  a  salutary  Excitement,  or  mild  Fever,  sufficient  to  prevent 
the  access  of  the  most  malignant  diseases — but,  like  these  agents,  they  have 
actually  arrested  and  cured  such  diseases  after  they  had  fairly  and  fully  com- 
menced. A  stone,  a  ring,  with  a  history  real  or  supposed ;  a  verse  of  the 
Koran  or  the  Bible  sewn  in  a  piece  of  silk — these  worn,  now  on  one  part  of 
the  body,  now  on  another,  have  inspired  a  mental  firmness  and  induced  a 
corporeal  steadiness  which  have  enabled  the  wearer  to  defy  the  united  influ- 
ence of  Epidemic  and  Contagion.  If  the  Arabs  have  still  their  talismans, 
and  the  Indians  their  amulets,  the  Western  nations  have  not  ceased  to  vaunt 
the  cures  and  other  miracles  effected  by  their  relics,  their  holy  wells,  and  holy 
water.  When  we  boast  of  the  success  of  a  particular  measure,  we  say  it 
acted  like  a  Charm.  What  is  a  charm  ? — whence  its  origin  ?  It  is  a  cor- 
ruption of  the  Latin  word  Carmen,  a  Song  or  Verse.  In  all  times  and  in 
all  countries,  there  have  been  men  who  have  found  their  advantage  in  play- 
ing upon  the  ignorance  of  their  fellow-men  ;  he  that  would  appear  wiser  than 
another  has  always  had  recourse  to  some  kind  of  imposture  ;  and  as  priest, 
poet,  prophet,  and  physician  were  often  united  in  one  person,  it  was  not  won- 
derful that  such  person  should  clothe  his  mummery  and  mysticism  in  verse. 
To  be  able  to  read  or  spell  was,  at  one  time,  a  mark  of  superior  wisdom,  and 
he  who  could  do  so,  had  only  to  mutter  his  "  spell"  to  cure  or  kill.  From 
the  earliest  antiquity,  we  find  charms  a  part  of  medical  practice  ;  Homer,  in 
his  Odyssey,  introduces  the  sons  of  Autolycus  charming  to  stanch  blood  ;  the 
physicians  of  Egypt  and  India  are  to  this  day  charmers  ;  the  north  men  com- 
posed Rhunic  rhymes  to  charm  away  disease.  Indeed,  with  the  Norwegians 
and  Icelanders  verse  or  song  was  supposed  to  be  all-powerful ;  one  of  their 
poets  thus  expresses  the  belief  of  his  time  and  country  in  this  respect :  "  I 
know  a  song  by  which  I  can  soften  and  Enchant  the  arms  of  my  enemies,  and 
render  their  weapons  harmless.  I  know  a  song  which  I  need  only  to  sing 
when  men  have  loaded  me  with  bonds  ;  for  the  moment  I  sing  it  my  chains 
fall  in  pieces,  and  I  walk  forward  at  liberty.  I  know  a  song  useful  to  all  the 
children  of  men  ;  for  as  soon  as  hatred  inflames  them  I  sing  it,  and  their  hate 
ceases.  I  know  a  song  of  such  virtue,  that  I  can  hush  the  winds  with  it,  .and 
subdue  the  storm  to  a  breath." 

Such,  Gentlemen,  was  the  origin  of  Enchantment,  or  Incantation,  terms  bpr- 
rowed  from  the  Latin  verb  Canto,  I  sing.  With  the  Jews,  the  simple  enun- 
ciation of  their  mystical  word  Abracalan,  was  sufficient  to  inspire  the  confi- 
dence that  baffled  disease ;  nay,  Quintus  Seyerinus  Samonicus  vaunted  his 
success  in  the  cure  of  the  hemitritic  or  double  tertian  fever,  by  pronouncing 
mysteriously  the  word  Abracadabra,  a  phonic  combination  of  his  own  inven- 
tion !  At  this  very  hour,  the  Caffre  rain-maker,  the  Cingalese  devil-dancer, 
and  the  Copper  Indian  sorcerer,  with  their  charms  and  chants,  are  enabled 
to  work  changes  in  the  bodies  of  their  several  countrymen  that  put  the  b< 
science  of  the  schoolmen  to  shame.  That  these  act  by  inspiring  Confidence 
6imply,  may  be  seen  from  what  took  place  in  1625,  at  the  siege  of  Breda. 
44  That  city  from  a  long  siege,  suffered  all  the  miseries  that  fatigue,  bad  pro- 
visions, and  distress  of  mind  could  bring  upon  its  inhabitants.  Among  other 
misfortunes,  the  scurvy  made  its  appearance,  and  carried  off  great  numbers. 
This,  added  to  other  calamities,  induced  the  garrison  to  incline  towards  a 
surrender  of  the  place,  when  the  Prince  of  Orange,  anxious  to  prevent  its 
loss,  and  unable  to  relieve  the  garrison,  contrived,  however,  to  introduce  let- 
ters to  the  men  promising  them  the  most  speedy  assistance.  These  were 
accompanied  with  medicines  against  the  scurvy  said  to  be  of  preat  price,  but  of 
still  greater  efficacy  ;  many  more  were  to  be  sent  to  them.  The  effects  of  the 
deceit  were  truly  astonishing.  Throe  small  vials  of  medicine  were  given  to<  ach 
physician.  It  was  publicly  given  out  that  three,  or  four  drops  were  sufficient 
to  impart  a  healing  virtue  to  a  gallon  of  water.  [Mark  this,  Homoeopa- 
thieta !]  We  now  displayed  our  wonder  working  balsams.  Noi  even  were 
the  commanders  let  into  the  secret  of  the  client  upon  the  soldiers.     Tiny 


LECTURE   VIII.  165 

flocked  in  crowds  about  us,  every  one  soliciting  that  part  may  be  reserved 
for  his  use.  Cheerfulness  again  appears  in  every  countenance,  and  an  uni- 
versal faith  prevails  in  the  sovereign  virtues  of  the  remedies.  The  effect  of 
this  delusion  was  truly  astonishing ;  for  many  were  quickly  and  perfectly 
recovered.  Such  as  had  not  moved  their  limbs  for  a  month  before,  were  seen 
walking  the  streets  with  their  limbs  sound,  straight,  and  whole  !  They 
boasted  of  their  cure  by  the  Prince's  remedy." — [Ives''  Journal.]  And  what 
"was  this  remedy  ? — a  mere  sham  medicine,  Gentlemen  !  After  this,  do  I 
require  to  caution  you,  when  you  visit  your  patients,  not  to  put  on  a 
lugubrious  or  desponding  look  before  them  ?  Such  conduct,  on  the  part  of  a 
medical  man,  is  unpardonable ;  yet  there  are  practitioners  so  base  and  sordid 
as  to  make  it  a  part  of  their  policy  to  represent  the  malady  of  every  patient 
as  dangerous.  These  find  their  profit  in  croaking  ;  for  it  is  a  course  of  con- 
duct that  almost  infallibly  contributes  to  keep  up  disease.  To  God  and  their 
consciences  I  leave  these  men. 

Such  of  you  as  might  be  disposed  to  question  the  depressing  influence  of  a 
long  face  upon  the  sick,  may  read  the  history  of  Lord  Anson's  voyages  with 
profit.  There  you  will  find  it  recorded,  "  that  whatever  discouraged  the 
seamen,  or  at  any  time  damped  their  hopes,  never  failed  to  add  new  vigour 
to  the  distemper,  (the  Scurvy,)  for  it  usually  killed  those  who  were  in  the 
last  stages  of  it,  and  confined  those  to  their  hammocks  who  were  before 
capable  of  some  kind  of  duty."  And  this  is  in  perfect  accordance  with  the 
observation  of  Solomon,  that  "  a  merry  heart  doeth  good  like  medicine,  but  a 
broken  spirit  drieth  the  bones." 

Let  me,  therefore,  counsel  you  not  only  to*assume  a  cheerful  look  in  the 
presence  of  the  sick,  but  endeavour  at  the  same  time 

To  render  with  your  precepts  less 

The  sum  of  human  wretchedness, 

And  strengthen  man  with  his  own  mind. 
What  are  all  your  trumpery  Pathology  and  Dissecting-Room  knowledge 
compared  with  this  ?  You  may  dissect  dead  bodies  for  twenty  years,  and 
never  be  one  whit  the  wiser  on  the  mode  of  influencing  the  motions  of  the 
living.  Now,  this  brings  to  my  mind  certain  lines  of  a  cotemporary  poet, 
the  celebrated  Beranger  ;  but  as  some  of  you  may  not  understand  the  French 
language,  I  shall  offer  no  apology  for  giving  his  sentiments  in  my  own  not 
over  poetical  English  : — 

Was  ever  such  an  ass  as  that 

Whp  hoped,  by  slicing  mutton-fat, 

And  pulling  candle-wicks  to  pieces, 

To  tell  why  Light  should  spring  from  Greases  ? 

Yes,  one — that  still  more  precious  fool, 

Who  in  the  anatomic  school 

Expected  with  dissecting  knife 

To  learn  from  Death  the  laws  of  Life  ! 

Ha  !  ha!  when  sick  myself,  I'd  rather 

From  some  old  nurse  a  "  wrinkle  "  gather, 

Than  trust  to  such  pedantic  pate 

To  cure  my  frame's  disordered  state  ! 
But,  seriously,  Gentlemen,  I  have  known  a  great  many  first-rate  anatomists 
in  my  time ;  yet  there  are  old  women  who  never  saw  the  inside  of  a  dead 
bodv,  whom  I  would  sooner  consult  in  my  own  case  than  any  of  these  hair- 
splitting gentry.  These  men  are  mere  geographers,  who  will  point  out  rivers 
and  towns,  if  I  may  say  so, — corporeal  hills,  and  dales  and  plains, — but  who 
know  nothing  of  the  manners,  customs,  or  mode  of  influencing:  the  animated 
atoms  constantly  entering  into  and  departing  from  them.  If  any  such  me- 
chanical-minded creature  presume  hereafter  to  mystify  you  on  this  point,  tell 
him  to  watch  the  wounded  of  contending  armies  ;  and  ask  him  to  explain  to 
you  why  the  same  description  of  injuries  which  heal  with  rapidity  when  oc-  ' 


166  LECTURE  VIII. 

curring  in  the  persons  of  the  victors,  too  often  prove  intractable,  or  even 
fatal  to  the  vanquished  !  He  might  dissect  their  dead  Nerves  as  clean  as  he 
pleased,  and  never  find  out  that  the  living  body  of  man  may  be  either  weak- 
ened or  strengthened  through  the  medium  of  his  own  Mind.* 

The  depressing  power  of  Grief  is  familiar  to  every  body  ;  but  there  are 
cases  where  a  reverse  effect  may  take  place  from  it — and  Shak6peare,  with 
his  usual  accuracy  explains  the  reason  of  this. 

In  Poison  there  is  Physic — and  these  news 
Having  been  well,  that  would  have  made  me  sick, 
Being  Sick,  have  in  some  measure  made  me  Well ; 
And  as  the  wretch,  whose  fever-weakened  limbs, 
Like  strengthless  hinges  buckle  under  life, 
Impatient  of  his  fit,  breaks  like  a  fire 
Out  of  his  keeper's  arms,  even  so  my  limbs, 
Weakened  with  Grief,  being  now  Enraged  with  Grief, 

Are  THRICE  THEMSELVES. 

The  strength  imparted  to  the  constitution  in  cases  of  this  nature,  has  a  re- 
lation to  the  novel  atomic  revolutions  caused  by  desperation  ;  or  that  deter- 
mination to  act  in  an  energetic  manner,  which  so  often  comes  upon  a  man  in 
his  extremity.  Such  reaction  resembles  the  glow  that  succeeds  the  sudden 
shock  of  a  cold  shower-bath.  There  are  persons  whom  a  slow  succession  of 
petty  misfortunes  would  worry  to  death ;  but  who,  on  sudden  and  apparently 
overwhelming  occasions,  become  heroes. 

It  will  be  readily  admitted,  by  all  who  have  profited  by  their  experience 
of  life,  that  one-half  the  worH  live  by  taking  advantage  of  the  passions  and 
prejudices  of  the  other  half.  The  parent  of  prejudice  is  ignorance  ;  yet 
there  is  no  man  so  ignorant  but  who  knows  something  which  you  or  I  may 
not  know.  The  wisest  judges  have  played  the  fool  sometimes  from  ignorance ; 
they  have  allowed  themselves  to  be  gulled  by  individuals  of  a  class  they  de- 
spise. Poor,  decrepid,  ill-educated  females,  calling  themselves  witches,  have 
imposed  upon  the  ablest  and  most  learned  men  of  a  nation.  Lord  Bacon  and 
Sir  Ma,thew  Hale  believed  in  witchcraft;  nay,  the  latter  judge  went  on  so 
far  as  to  sentence  to  death  wretches  supposed  to  be  convicted  of  it,  and  they 
were  executed  accordingly.  Samuel  Johnson  was  a  believer  in  ghosts  and 
the  second  sight.  Where,  then,  is  the  country  so  enlightened  that,  upon  some 
points,  the  wisest  and  best  may  not  be  mystified  ?  If  such  a  country  exists, 
it  must  be  England  at  the  present  moment ;  if  there  be  a  profession  in  which 
deception  is  never  practised,  it  must  be  medicine.  Happy  England  !  happy 
medicine !  where  all  is  perfect  and  pure — where  the  public  are  neither  cheated 
by  an  echo,  nor  led  by  a  party  for  party  interests !  Here  collegiate  corrup- 
tion is  unknown,  and  corporate  collusion  is  a  mere  name  ;  here  we  have  no 
diplomas  or  certificates  to  buy — no  reviewers  to  bribe — no  humbug  schools 
— no  venal  professors ;  here,  having  no  mote  in  our  own  medical  eye,  we  can 
the  better  distinguish  and  pluck  out  that  of  our  neighbours.  Who  will 
doubt  our  superiority  in  this  respect  over  all  other  nations  of  the  earth  ?  Or 
who  will  question  me  in  what  that  excellence  principally  consists  ?  Scape- 
grace, sceptic,  read  Dr.  Hawkins— read  Dr.  Bisset  Hawkins'  Continental 
Travels— and  you  will  there  find  it  recorded,  that  the  brightest  feature  of 
British  medicine— the  most  distinguished  point  of  excellence  in  English  treat- 
ment—is the  copious  blood-lettings  we  practice.  "  The  neglect  of  copious 
blood-lettings,"  quoth  Hawkins,  "is  the  greaterror  of  the  continental  hospitals!" 
Let  us  laugh,  then,  at  the  do-little  "  medecine  expectante"  of  the  French, 
ridicule  the  do-nothing  homoeopathy  of  the  Germans,  and  turn  up  our  lip  in 
derision  at  the  counter-stimulant  doctrines  of  the  Italians.     What  are  the 

*  The  remarks  in  the  text  apply  solely  to  the  Morbid  Anatomists— 1<>  those  who 
argue  from  the  end  us  if  it  were  t»e  beginning—not  to  the  philosophies 
4natomwte,whofbycomprahennvf)h  comparing  the  structure  of  one  tribe  oi  animals 
with  another,  have  arrived  at  the  Unity  of  S/ntcturc  of  nil  animals 


LECTURE  VIII.  167 

greatest  medical  professors  of  the  Continent,  in  comparison  -with  our  own 
meanest  apothecaries  even — to  say  nothing  of  our  leading  surgeons  and  phy- 
sicians— presidents  and  vice-presidents  of  learned  societies  ?     Only  look  at 
the  number  of  scientific  bodies  to  which  these  little  great  men  belong,  you 
will  find  their  names  enrolled  in  every  (so  called  !)  Literary  and  Scientific 
institution  throughout  the  country — astronomical,  botanical,  geological,  anti- 
quarian, royal !     Amiable  and  respectable  persons!  worthy  of  the  carriages 
in  which  you  ride,  and  the  arms  you  bear ;  you  are  gentlemen — friendly  and 
disinterested  gentlemen  ;  you  owe  your  elevation  to  your  own  industry  ;  you 
preserve  your  position  by  your  incorruptible  honesty  ;  you  recommend  your- 
selves, and  each  other,  neither  by  letter  nor  affection,  but  upon  the  score  of 
talent  and  integrity  solely  ;   you  are  all  honourable  men.     Unlike  the  "  hon- 
ourable'members"  of  a  certain  honourable  place,  who  have  been  purchased, 
you,  the  members  of  an  equally  "  honourable"  profession,  are  unpurchasable  ! 
This,  your  colleges  and  coteries  declare — this,  the  discriminating  world  be- 
lieves and  echoes.     Who  but  the  reptiles — the  few  that  never  think,  never 
reflect — would  answer,  all  is  not  gold   that  glitters  !     Gentlemen, 
what  is  the  difference  betwixt  a  guinea  and  its  counterfeit  ?     Do  not  both 
sparkle  with  equal  brightness  ?     Have  they  not  the  same  form,  the  same  ex- 
terior impress  ?     Can  the  eye  detect  the  imposture  ?     No  !  it  is  only  by  a 
comparative  trial  of  their  respective  weight  and  ring,  that  you  can  make  out 
the  difference.     Do  you  think  mankind  are  to  be  judged  in  any  other  way 
than  this  ?     Is  it  not  as  necessary,  for  a  person  to  be  a  successful  cheat,  that 
he  should  borrow  the  exterior  of  worth  and  integrity,  as  it  is  for  the  counter- 
feit guinea  to  bear  the  name  and  livery  of  the  coin  it  purposes  to  be,  before  it 
can  pass  for  genuine?     Be  not,  then,  satisfied  with  fine  names  and  appear- 
ances only ;  do  not  take  men  for  what  they  pretend  to  be  solely  by  their 
manner  or  title,  because  they  are  doctors  of  this  college,  or  professors  of  that 
university.     What  is  a  professorship  but  &  place?     "  He  who  has  the  best 
talents  for  getting  the  office,  has  most  commonly  the  least  for  filling  it ;  and 
men  are  made  moral  [medical]  and  mathematical  teachers,  by  the  same  trick 
and  filthiness  with  which  they  are  made  tide-waiters  and  clerks  of  the  kit- 
chen."— Sydney  Smith.     Depend  upon  it,  professors  thus  elected  will  always 
stand  by  each  other — right  or  wrong,  they  will  always  support  the  same 
system.     In  this,  they  do  no  more  than  the  members  of  the  swell-mob,  who 
work  together  by  coterie  and  collusion.     Like  these  professors,  too,  they  are 
all  very  respectable  in  their  appearance,  some  of  them  doing  business  in  a 
carriage  even  ! 

Where  is  the  individual  that  has  not  his  moral  as  well  as  his  physical 
weakness  ?  Upon  this  point,  at  least,  we  are  all  liable  to  be  overreached. — 
Here  we  are  every  one  of  us  imbecile  as  the  infant ;  for  we  are  placed  as 
completely  at  the  mercy  of  the  Charlatan,  as  the  child  is  at  the  disposal  of 
the  parent,  whose  mental  ascendancy  he  acknowledges.  Speak  to  the  prat- 
tler of  the  "  haunted  chamber,"  his  countenance  instantly  falls.  With  the 
adult,  assume  an  air  of  mystery,  mutter  darkly  and  indefinitely,  and  mark 
how  his  brain  will  reel.  Is  he  sane  ?  he  becomes  your  tool.  Has  he  come 
to  you  in  his  sickness  ?  you  gull  him  and  guide  him  at  your  pleasure.  But 
how  can  you  wonder  at  the  effects  of  this  kind  of  agency  on  individuals,  when 
you  have  seen  a  whole  nation  similarly  hood-winked  by  a  coterie  of  doctors  ? 
I  allude  to  what  was  done  when  the  cholera  first  appeared  in  England. — 
The  influence  of  fear,  in  disposing  to  spread  an  epidemic,  you  know  ;  the 
effect  of  confidence  in  strengthening  the  body  against  its  attacks,  you  also 
know.  What  was  the  conduct  of  the  College  of  Physicians  when  the  cholera 
broke  out  1  Did  they  try  to  allay  the  alarm  of  the  masses  ?  did  they  en- 
deavour to  inspire  them  with  confidence  and  hope,  that  their  bodies  might  be 
strengthened  through  their  minds  ?  No  !  they  publicly,  and  by  proclamation, 
declared  the  disease  to  be  contagious;  without  a  particle  of  proof,  or  the 
shadow  of  a  shade  of  evidence,  they  solemnly  announced  that,  like  the  small- 


168  LECTURE  VIII. 

pox,  it  was  communicable  from  man  to  man  !     That  was  the  signal  to  get  up 
their  cholera  boards ;  and  cholera  bulletins,  forsooth,  must  be   published-     1 
had  just  then  returned  from  India,  where,  though  I  had  seen  more  case9  of 
cholera  than  all  the  fellows  of  the  college  put  together,  I  never  heard  of  cholera- 
contagion  ;  no,  nor  cholera  boards.     In  the  far  East,   the  authorities,  civil, 
military,  and  medical,  acted  with  firmness  ;  what  they  could  not  arrest,  they 
awaited  with  fortitude  ;  they  placed  themselves  and  those  committed  to  their 
care  at  the  mercy  of  the  great  Disposer  of  Events  ;  while  in  England,  enlight- 
ened England,  the  leading  law-givers,  under  the  influence  of  the  leading  medical 
men,  introduced  acts  that  disgraced  the  statute-book,  and  permitted  medical 
jobs  to  be  got  up  that  did  anything  but  honour  to  the  medical  profession.     A 
new  tax  was  actually  levied  to  defray  the  salaries  of  their  cholera  boards  ! 
The  consequences  of  these  measures  might  have  been  foreseen.     Throughout 
the  country  universal  panic  was  spread,  and  universal  gloom  prevailed.    The 
rich  shut  themselves  up  in  their  houses,  each  in  terror  of  his  neighbour's 
touch  ;  the  middle  classes  suffered  from  the  general  stagnation  which  ensued 
in  consequence  :  every  trade,  but  the  drug  trade,  languished  or  stood  still ;  and 
the  poor,  when  taken  ill — for  the  disease  was  chiefly  confined  to  that  class — 
were,  by  act  of  parliament,  dragged  from  their  homes,  and  conveyed  to  the 
cholera  hospitals,  where,  if  they  did  not  perish  of  the  prostration  induced  by 
their  removal,  they  had  salt  and  water  injected  into  their  veins  by  the  medical 
mad-men  in  charge  !     Debarred  the  society  of  their  nearest  and  dearest  re- 
latives, and  tortured  in  every  possible  way  by  their  pedantic  doctors,  how 
few  of  these  unfortunates  escaped  from  the  pest-houses  in  which  they  were 
so  inhumanly  immured  !     All  this,  the  leading  men  of  the  country,  peers, 
judges,  and  members  of  parliament,  saw  and  permitted,  from  a  puerile  dread 
of  the  phantom  contagion,  which  the  ignorance  or  cupidity  of  the  College  of 
Physicians  had  conjured  up.     To  what  miseries  will  not  the  feeble  submit, 
when  under  the  influence  of  intimidation,  if 

Even  the  wisest  and  the  hardiest  quail 
To  any  goblin  hid  behind  a  veil ! 

Is  not  this  a  subject  for  deep  reflection  ?  To  some  it  may  suggest  a  feel- 
ing like  shame.  Let  me  speak  of  Shame.  Generally  speaking,  this  is  a 
depressing  passion,  and  under  its  influence  men  sometimes,  and  women  daily, 
commit  suicide.  I  will  give  you  an  instance  where  it  had  the  reverse  effect. 
The  girls  of  Miletus,  a  town  in  Greece,  were  seized  with  a  mania  that  led 
them  to  believe  self-destruction  an  act  of  heroism  ;  and  many  accordingly  de- 
stroyed themselves.  Physic  and  argument  having  been  alike  ineffectually 
tried,  the  authorities,  to  prevent  the  spread  of  this  fatal  rage,  ordered  the 
bodies  of  the  suicides  to  be  dragged  naked  through  the  streets  of  the  city. 
From  that  moment  the  mania  ceased.  But  everything  depends  upon  a  con- 
tingencvi  whether  a  particular  passion  act  as  a  depressant  or  a  tonic  in  dis- 
ease. In  the  case  of  Shame,  the  past  and  the  future  make  a  great  deal  of 
difference. 

Some  of  you  may,  perhaps,  feel  inclined  to  remind  me  of  the  efficacy  of 
Fear  in  the  Cure  of  diseases ;  but  in  this  case  the  fear  induced  must  neither 
be  a  dread  of  the  disease  nor  its  event,  but  a  dread  of  some  circumstance  com- 
pletely unconnected  with  it.  Thus,  Sir  John  Malcom,  in  his  History  of 
Persia,  tells  us  of  a  certain  Hakeem  who  cured  ague  by  the  bastinado.  In 
this  case  the  Persian  doctor  availed  himself  of  the  double  influence  of  fear 
and  pain,  neither  of  which  was  contingent  upon  the  disease.  The  effect  of 
Terror  in  removing  Jooth-ache  is  familiar  to  many  who  have  knocked  at  a  den- 
tist's door.  The  gout,  too,  has  been  cured  and  caused  by  every  passion  you 
can  name.  There  does  not  pass  a  day  but  we  hear  of  people  being  frigh'ten- 
ed  into  epileptic  fits  ;  yet  Boerhaavo  terrified  away  an  epilepsy  from  a  school 
where  ii  prevailed,  by  threatening  to  burn  with  B  red-hot  poker  the  first  boy 
that  should  have  another  paroxysm.     1  h;ive  known  asthma  cured  by  Rage. 


LECTURE  VIII.  169 

and  also  by  Grief;  yet,  if  we  may  believe  what  we  hear,  people  occasionally 
choke  of  both  !  Few  medical  men  will  dispute  the  influence  of  a  passion  in 
the  cure  of  Ague.  Mention  any  mental  impression,  such  as  Faith,  Fear, 
Rage,  or  Joy,  as  having  succeeded  in  this  affection,  and  they  doubt  it  not ; 
but  superadd  to  the  patient's  state  a  palpable  change  of  volume,  or  structure, 
such  as  an  enlarged  gland  or  ulcer,  and  they  smile  in  derision  at  the  efficacy  of 
a  charm.  Extremes  in  scepticism  and  credulity  are  equally  diseases  of  the 
mind.  The  healthy  brain  is  ever  open  to  conviction  ;  and  he  who  can  be- 
lieve that  the  Obi-charm,  or  the  magic  of  a  monarch's  touch,  can  so  operate 
on  the  nervous  system  as  to  interrupt  or  avert  the  mutations  of  motion  and 
temperature  constituting  an  ague-fit,  should  pause  before  he  deny  their  in- 
fluence over  an  ulcer  or  a  tumor,  which  can  only  be  developed  or  removed  by 
or  with  change  of  temperature.  Indeed,  from  what  we  have  already  said,  it 
is  impossible  for  any  individual  to  be  the  subject  of  any  mental  impression 
without  experiencing  a  chill  or  a  heat,  a  tremor  or  a  spasm,  with  a  greater 
or  less  change  in  the  atomic  relations  of  every  organ  and  secretion.  Baron 
Alibert  gives  the  case  of  a  Parisian  lady,  who  had  a  large  wen  in  the  neck — 
a  goitre — which,  from  its  deformity,  occasioned  her  much  annoyance.  That 
tumor,  which  had  resisted  every  variety  of  medical  treatment,  disappeared 
during  the  Reign  of  Terror — a  period  when  this  lady,  like  many  others  of 
her  rank,  experienced  the  greatest  mental  agony  and  suspense.  The  agony 
and  suspense  in  that  case  referred  to  a  contingency  altogether  unconnected  with 
her  disease.  The  mere  act  of  dwelling  upon  sickness  will  keep  it  up  ;  while 
whatever  withdraws  the  mind  from  it  is  beneficial.  In  my  own  experience, 
abscesses  of  considerable  magnitude  have  been  cured  both  by  fear  and  joy. 
Few  surgeons  in  much  practice  have  been  without  the  opportunity  of  satis- 
fying themselves  that  purulent  swellings  may  recede  under  the  influence  of 
fear.  They  have  assured  themselves  of  the  presence  of  matter — they  propose 
to  open  the  tumor — the  frightened  patient  begs  another  day,  but  on  the  mor- 
row it  has  vanished. 

Akin  to  Terror  is  Disgust,  or  that  feeling  which  a  person  naturally  en- 
tertains when,  for  the  first  time,  he  handles  a  toad  or  an  asp.  This  passion 
has  worked  wonders  in  disease.  The  older  physicians  took  advantage  of  it 
in  their  prescriptions ;  for  they  were  very  particular  in  their  directions  how 
to  make  broth  of  the  flesh  of  puppies,  vipers,  snails,  and  milipedes  !  The 
celebrated  Mohawk  Chief,  Joseph  Brandt,  while  on  a  march,  cured  himself  of 
a  tertian  ague,  by  eating  broth  make  from  the  flesh  of  a  rattlesnake  !  Here 
the  cure  must  have  been  altogether  the  effect  of  disgust,  for  in  reality  the 
flesh  of  a  rattlesnake  is  as  perfectly  innocuous,  and  quite  as  nutritious  as.  the 
flesh  of  an  eel.  Mr.  Catlin,  in  his  Letters  and  Notes  on  the  North  American 
Indians,  tells  us  that  when  properly  broiled  and  dressed  he  found  the  rattle- 
snake to  be  "  the  most  delicious  food  of  the  land."  But  when  you  come  to 
think  of  the  living  reptile  and  the  venom  of  his  fang,  who  among  you  could  at 
first  feed  upon  such  fare  without  shuddering,  shivering,  shaking — without, 
in  a  word,  experiencing  the  horrors  and  horripulations  of  ague  !  Spider-web, 
soot,  moss  from  the  dead  man's  skull,  the  touch  of  a  dead  malefactor's  hand, 
are  at  this  very  hour  remedies  with  the  English  vulgar  for  many  diseases. 
With  the  Romans  the  yet  warm  blood  of  the  newly-slain  gladiator  was 
esteemed  for  its  virtues  in  epilepsy.  Even  at  this  day,  in  some  countries  of 
Europe,  the  lower  orders  cure  the  same  disorder  by  drinking  the  blood  as  it 
flows  from  the  neck  of  the  decapitated  criminal.  In  the  last  century,  a  live 
toad  hung  round  the  neck  was  much  esteemed,  by  the  same  class  of  people, 
for  its  efficacy  in  stopping  bleeding  at  the  nose.  Now  t^iat  the  toad  is  known 
to  be  free  from  venom,  it  might  not  be  so  successful  as  it  once  was  in  this  in- 
stance. Any  temporary  benefit,  real  or  supposed,  which  has  accrued  from 
the  employment  of  the  Leech,  has  appeared  to  me  to  be  in  many  instances  the 
effect  of  the  Horror  the  patient  very  naturally  entertained  for  the  reptile. 

A  consideration  of  the  power  by  which  the  Passions  cure  and  cause  dig- 


170  LECTURE  VIII. 

eases,  affords  at  once  the  best  refutation  of  medical  error,  and  the  most  per- 
fect test  of  medical  truth.  By  this  test,  I  am  willing  that  my  doctrine^  should 
stand  or  fall.  What  are  the  Passions  ?  Cerebral  movements — actions  of 
the  internal  Brain,  produced  by  external  causes — whicn,  by  influencing  its 
atomic  revolutions,  influence  every  right  or  wrong  action  of  the  body.  Take 
the  influence  of  Fear  simply — what  disease  has  not  this  passion  caused  ? — 
what  has  it  not  cured  ? — inducing  right  motions  in  one  case,  wrong  in  another. 
The  mode  of  action  of  a  passion,  then,  establishes  beyond  cavil  not  only  the 
unity  of  disease,  but  the  unity  of  action  of  remedy  and  cause.  What  does 
the  proper  treatment  of  all  diseases  come  to  at  last,  but  to  the  common  prin- 
ciple of  reversing^  the  existing  motion  and  temperature  of  various  parts  of  the 
body  ?  Do  this  in  a  diseased  body,  and  you  have  health — do  the  same  in 
health,  and  you  reproduce  disease.  Whatever  will  alter  the  movements  of 
a  living  being  will  cure  or  cause  disease.  This,  then,  is  the  mode  in  which 
all  our  remedies  act.     Just  observe  the  effect  of 

Baths. 

In  what  disease  have  not  Baths  been  recommended  ? — and  in  what  man- 
ner can  they  cure  or  ameliorate,  but  by  change  of  temperature — by  change 
of  motion  ?  Put  your  hand  into  ice-water — does  it  not  shrink  and  become  di- 
minished in  size  ?  Place  it  in  water  as  hot  as  you  can  bear — how  it  swells 
and  enlarges  !  You  see,  then,  that  change  of  temperature  necessarily  implies 
change  of  motion  ;  and  that  change  of  motion  produces  change  of  tempera- 
ture, you  have  only  to  run  a  certain  distance  to  be  satisfied  ;  or  you  may 
6ave  yourself  the  trouble,  by  looking  out  of  your  window  in  a  winter  morn- 
ing, when  you  will  see  the  hackney  coachmen  striking  their  breasts  with  their 
arms  to  warm  themselves.  Depend  upon  it  they  would  not  do  that  for  no- 
thing. Heat,  then,  so  far  from  being  itself  a  material  substance,  as  Black  and 
other  chemists  assert,  is  a  mere  condition  of  matter  in  motion — it  is  no  more  a 
substance  than  colour,  sound,  ox  fluidity.  What  can  be  greater  nonsense  than 
an  "  imponderable"  substance — as  Heat  and  Light  have  been  sometimes 
called?  That  only  is  matter  or  substance  which  can  be  weighed  and 
measured — and  this  may  be  done  with  invisible  as  well  as  visible  things, — in 
the  case  of  a  Gas  for  example ;  however  attenuated,  a  gas  can  both  bo 
weighed  and  measured. 

I  am  often  asked,  what  baths  are  safest,  as  if  everything  by  its  fitness  or 
unfitness  is  not  safe,  or  the  reverse.  The  value  of  all  baths  depends  upon 
their  fitness ;  and  that,  in  many  instances,  can  only  be  known  by  trial.  It 
depends  upon  constitution,  more  than  upon  the  name  of  a  disease,  whether 
particular  patients  shall  be  benefitted  by  one  Bath  or  another.  Generally 
speaking,  when  the  skin  is  hot  and  dry,  a  Cold  Bath  will  do  good  ;  and  when 
chilly,  a  Hot  Bath.  But  the  reverse  sometimes  happens.  The  cold  stage  of 
Ague,  may  at  once  be  cut  short  by  a  cold  bath.  I  have  seen  a  shivering  hy- 
pochondriac dash  into  the  cold  plunge  bath,  and  come  out  in  a  minute  or  two 
perfectly  cured  of  all  his  aches  and  whimsies..  But  in  cases  of  this  nature, 
every  thing  depends  upon  the  glow  or  reaction,  which  the  Bath  produces  :  and 
that  has  as  much  to  do  with  surprise  or  shock  as  with  the  temperature  of  the 
bath.  I  have  seen  a  person,  with  a  hot  dry  skin,  go  into  a  warm  bath,  and 
come  out  just  as  refreshed  as  if  he  had  taken  a  cold  one.  In  that  case  the 
perspiration  which  it  excited  must  have  been  the  principal  means  of  relief. 

So  far  as  my  own  experience  goes,  I  prefer  the  cold  and  tepid  shower- 
baths,  and  the  cold  plunge  bath  to  any  other;  but  there  arc  cases  in  which 
these  disagree,  and  I,  therefore,  occasionally  order  the  warm  or  vapour  bath 
instead. 

In  diseases  termed  "inflammatory,"  what  measure  so  ready  or  so  effica- 
cious as  to  dash  a  pitcher  or  two  of  cold  water  DTer  the  patient — Colli  Affu- 
tion,  as  it  is  called  ?     Whilst  serving  in  the  Army,  1  cured  hundreds  ui'  intlam- 


LECTURE  VIII.  171 

matory  fevers  in  this  manner — fevers,  that,  in  the  higher  ranks  of  society, 
under  the  bleeding  and  starving  systems,  would  have  kept  an  apothecary  and 
physician — to  say  nothing  of  nurses  and  cuppers — visiting  the  patient  twice 
or  thrice  a-day  for  a  month,  if  he  happened  to  live  so  long. 
Gentlemen,  with  the  cold  dash  you  may  easily, 

"  While  others  meanly  take  whole  months  to  slay," 
Produce  a  cure  in  half  a  summer's  day. 

That  being  the  case,  do  you  wonder  that  prejudices  should  still  continue 
to  be  artfully  fostered  against  so  unprofitable  a  mode  of  practice  ?  Why  do 
not  the  gullible  public  examine  for  themselves  1  Why  will  they  continue  to 
bribe  their  medical  men  to  keep  them  ill  1  In  their  shops  and  out  of  their 
shops,  people  generally  enact  two  very  different  characters.  Behind  their 
counters  they  take  advantage  of  their  customers  in  every  possible  way ;  but 
the  moment  they  get  out  of  doors,  the  same  persons  drop  the  knave  and  be- 
come the  dupe.  The  merchant  and  tradesman,  who  buy  cheap  and  sell  dear 
— the  landowner  and  farmer,  who  keep  up  the  corn  laws  by  every  possible 
sophistry — the  barrister  and  attorney,  who  rejoice  and  grow  fat  on  the  imper- 
fections and  mazes  of  the  law — the  (Mergyman  and  his  clerk,  whose  gospel 
knowledge  and  psalm-singing,  are  too  often  in  juxta-position  with  tithes  and 
burial  fees — become  all  perfect  lambs  when  they  leave  their  respective  voca- 
tions ;  each  giving  the  others  credit  for  a  probity  and  disinterestedness  in 
their  particular  line,  which  himself  would  laugh  at  as  sheer  weakness,  were 
any  body  to  practise  it  in  his  own  !  With  the  most  childish  simplicity,  peo- 
ple ask  their  doctor  what  he  thinks  of  this  practice,  and  what  he  thinks  of  the 
other— never  for  a  moment  dreaming  that  the  man  of  medicine's  answer,  like 
the  answer  of  every  other  man  in  business,  will  be  sure  to  square  with  his 
own  interests.  Instead  of  using  the  Eyes  that  God  has  given  them,  they  shut 
them  in  the  most  determined  manner,  that  their  Ears  may  be  the  more  sure 
ly  abused.  *'  What  a  delightful  person  Dr.  Such-a-one  is,"  you  will  hear 
persons  say  ;  "he  is  so  very  kind,  so  very  anxious  about  me."  Just  as  if  all 
that  affected  solicitude,  all  that  pretty  manner  of  his,  were  not  part  and  par- 
cel of  the  said  good  doctor's  stock  in  trade.  Silly,  simple  John  Bull !  Why 
will  you  pin  your  faith  to  fallible  or  fallacious  Authority,  when  you  may  get 
the  truth  so  easily  by  a  little  personal  Examination  !  To  be  able  to  discrimi- 
nate in  the  choice  of  a  physician,  aad  to  guard  against  medical  imposture, 
would  not  cost  you  half  the  time,  nor  anything  like  the  trouble,  of  mastering 
the  inflections  of  ,  verbero,  or  Amo,  amare  !     Which  kind  of  know- 

ledge is  of  most  use  in  life,  I  leave  to  pedants  and  philosophers  to  settle  be- 
tween them.     Meantime,  I  shall  beg  your  attention  to  the  subject  of 

Exercise. 

The  effects  of  mere  motion  upon  the  body  are  sometimes  very  surprising. 
Only  think  of  iibrse-exercise  curing  people  of  consumption  !  A  case  of  this 
kind,  you  remember,  I  gave  you,  on  the  authority  of  Darwin.  I  knew  a  gen- 
tleman, who  was  affected  with  habitual  asthma,  but  who  breathed  freely 
when  in  his  gig.  I  know,  at  this  moment,  another,  afflicted  with  giddiness, 
who  is  immediately  "himself  again,"  when  on  horseback.  A  dropsical  fe- 
male, who  came  many  miles  to  consult  me,  not  only  felt  corporeally  better 
when  she  got  into  the  coach,  but  her  kidneys  acted  so  powerfully  as  to  be  a 
source  of  much  inconvenience  to  her  during  the  journey.  This  corporeal 
change  she  experienced  every  time  she  came  to  see  me.  The  motion  of  the 
circular  swing  has  cured  mania  and  epilepsy.  But  what,  as  we  have  repeat- 
edly shown,  is  good  for  one  patient  is  bad  for  another.  You  will  not,  there- 
fore, be  astonished  to  find  cases  of  all  these  various  diseases,  where  aggrava- 
tion may  have  been  the  work  of  horse  exercise,  and  the  other  motions  we  have 
mentioned. 

Exercise  of  the  muscles,  in  any  manner  calculated  to  occupy  the  patient's 


172  LECTURE  VIII. 

whole  attention,  will  often  greatly  alleviate  every  kind  of  chronic  disease.  Dr. 
Cheyne  was  not  above  taking  a  useful  hint  on  this  point  from  an  Irish  charla- 
tan. "  This  person,"  says  Dr.  Cheyne,  "ordered his  (epileptic)  patients  to 
walk,  those  who  were  not  enfeebled,  twelve,  fifteen,  or  even  twenty  miles  a- 
day.  They  were  to  begin  walking  a  moderate  distance,  and  they  were  gra- 
dually to  extend  their  walks,  according  to  their  ability.  In  some  of  the 
patients,  a  great  improvement  took  place,  both  with  respect  to  digestion  and 
muscular  strength  ;  and  this  was  so  apparent  in  a  short  time,  that  ever  since 
this  luminary  shone  upon  the  metropolis  of  Ireland,  most  of  our  patients  af- 
fected with  epilepsy,  have  been  with  our  advice  peripatetics."  Exercise, 
then,  is  one  of  our  best  remedial  means.  Moreover,  it  may  be  turned  to  very 
great  advantage  in  our  common  domestic  matters.  Were  I  to  tell  you  all  at 
once,  that  you  might  keep  yourselves  warm  by  a  single  log  of  wood  all  the 
winter  over,  you  would  think  I  was  jesting,  but  really  the  thing  may  be  done. 
I  believe  we  owe  the  discovery  to  our  friends  across  the  water,  the  Ameri- 
cans ;  and  I  may  as  well  give  you  the  recipe  : — -'Take  a  log  of  wood  of 
moderate  size,  carry  it  to  the  upper  garret,  and  throw  it  from  the  window 
into  the  street,  taking  care,  of  course,  not  to  knock  any  body  on  the  head ; 
this  done,  run  down  stairs  as  fast  as  yo*u  can ;  take  it  up  again  to  the  garret 
and  do  as  before.  Repeat  the  process  until  you  are  sufficiently  warm — when 
— you  may  lay  by  the  log  for  another  occasion  !" 

"  One  of  our  reverend  bishops,  (who,  Sydenham  tells  us,  was)  famous  for 
prudence  and  learning,  having  studied  too  hard  a  long  while,  fell  at  length 
into  a  Hypochondriacal  disease  ;  which  afflicted  him  a  long  time,  vitiated  all  the 
ferments  of  the  body,  and  wholly  subverted  the  concoctions.  [Such,  Gentlemen, 
was  the  jargon  of  the  eminents  of  Sydenham's  time.]  He  (the  bishop)  had 
passed  through  long  steel  courses  more  than  once,  and  had  tried  almost  all  sorts 
of  mineral  waters,  with  often-repeated  purges  and  antiscorbutics  of  all  kinds, 
and  a  great  many  testacious  powders  which  are  reckoned  proper  to  sweeten 
the  Blood  (!)  and  so  being  in  a  manner  worn  out,  partly  by  the  disease,  and 
partly  by  Physic  used  continually  for  so  many  years,  he  was  at  last  seized 
with  a  colliquative  looseness  which  is  wont  to  be  the  forerunner  of  death  in 
consumption  and  other  chronical  diseases  when  the  digestions  arc  wholly  de- 
stroyed. At  length  he  consulted  me  ;  I  presently  considered  that  there  was  no 
more  room  for  medicine,  he  having  taken  so  much  already  without  any  benefit ; 
for  which  reason  I  advised  him  to  ride  on  horseback,  and  that  first  he  should 
take  such  a  small  journey  as  was  agreeable  to  his  weak  constitution.  Had 
he  not  been  a  judicious  man,  and  one  that  considered  things  well,  he  would  not 
have  been  persuaded  so  much  as  to  try  such  a  kind  of  exercise.  I  entreated 
him  to  persist  in  it  daily,  till  in  his  own  opinion  he  was  well,  going  daily  far- 
ther and  farther,  till  at  length  he  went  so  many  miles,  as  prudent  and  moderate 
travellers  that  go  a  long  journey  upon  business  use  to  do,  without  any  regard 
to  meat  or  drink,  or  the  weather,  but  that  he  should  take  everything  as  it  hap- 
pens like  a  traveller.  To  be  short,  he  continued  this  method,  increasing 
fii&  journey  by  degrees,  till  at  length  he  rode  twenty  or  thirty  miles  daily, 
and  when  he  found  he  was  much  better  in  a  few  days,  being  encouraged  by 
such  a  wonderful  success,  he  followed  this  course  for  a  pretty  many  months, 
in  which,  as  he  told  me,  he  rode  many  thousand  miles  ;  so  that  at  length  he 
not  only  recovered,  but  also  regained  a  strong  and  brisk  habit  of  body.  Nor 
is  this  kind  of  exercise  more  beneficial  to  hypochondriacal  people  than  to 
those  that  are  in  a  consum])tion ;  whereof  some  of  my  relations  have  been 
cured  by  riding  long  journeys  by  my  advice  ;  for  1  knew  1  could  not  cure 
them  better  by  medicines  of  what  value  soever,  or  by  any  other  method. — 
Nor  i  .  t'nis  remedy  proper  only  in  small  indispositions,  accompanied  with  a 
firequ  nt  cough  and  leanness,  but  also  in  consumptions  that  are  almost  de- 
plorable when  the  looseness  above-mentioned  accompanies  the  night  sweats, 
wlii.  h  are  wont  to  be  the  forerunners  of  death  in  those  that  die  of  consump- 
tion.    To  be  short,  how  deadly  soever  a  consumption  is,  and  is  said  to  be — 


LECTURE  VIII.  173 

two-thirds  of  it  dying  who  are  spoiled  by  chronical  diseases— yet  I  sincerely 
assert,  that  mercury  in  the  French  pox,  and  the  Jesuits'  bark  in  agues,  are 
not  more  effectual  than  the  exercise  above-mentioned  in  curing  a  consumption, 
if  the  patient  be  careful,  and  the  sheets  be  well  aired,  and  that  his  journeys 
are  long  enough.  But  this  must  be  noted,  that  those  who  are  past  the  flower 
of  their  age,  must  use  this  exercise  much  longer  than  those  that  have  not 
yet  arrived  at  it;  and  this  I  have  learned  by  long  experience  which  scarce 
ever  failed  me.  And  though  riding  on  horseback  is  chiefly  beneficial  to  peo- 
ple that  have  a  consumption,  yet  riding  journeys  in  a  coach  is  sometimes 
very  beneficial.* 

The  poet  Coleridge,  while  at  Malta,  was  in  the  habit  of  attending  much  to 
those  about  him,  and  particularly  those  who  were  sent  there  for  pulmonary 
complaints.  "  He  frequently  observed  how  much  the  invalid,  at  first  land- 
ing, was  relieved  by  the  climate,  and  the  stimulus  of  change,  but  when  the 
novelty  arising  from  that  change  had  ceased,  the  monotonous  sameness  of  the 
blue  sky,  accompanied  by  the  summer  heat  of  the  clime,  acted  powerfully  as 
a  sedative,  ending  in  speedy  dissolution."  Is  not  this  a  proof  of  the  correct- 
ness of  my  previous  observation,  that  in  chronic  disorder  remedies  require  to 
be  frequently  changed  ?  The  benefit  to  be  derived  from  travelling,  often 
great  in  chronic  disorders,  is  partly  to  be  ascribed  to  the  change  of  motion, 
and  partly  to  change  of  air  and  scene.  Like  every  mode  of  treatment  pre- 
senting frequent  novelty,  travelling,  therefore,  offers  many  advantages  to  the 
invalid,  in  every  kind  of  chronic  or  habitual  disease.  How  often,  alas  !  do 
we  find  it  recommended  as  a  last  resource,  under  circumstances  where  it  must 
inevitably  hasten  the  fatal  catastrophe  !  The  breath  that  might  otherwise 
have  fanned  the  flame,  now  only  contributes  to  its  more  rapid  dissolution. — 
How  much  the  success  of  a  measure  depends  upon  time  and  season  ! 

I  must  say  a  few  words  about 

PiiASTERs,  Blisters,  Ointments,  &c. 

The  beneficial  influence  obtained  from  all  such  local  applications  depends 
upon  the  change  of  temperature  they  are  capable  of  producing.  Their  results 
will  vary  with  constitutions.  Most  patients,  who  suffer  from  chronic  disease, 
point  to  a  particular  spot  as  the  locality  where  they  are  most  incommoded  with 
"  cold  chills."  This  is  the  point  for  the  application  of  the  galbanum  or  other 
"  warm  plaster."  A  plaster  of  this  kind  to  the  loins  has  enabled  me  to  cure 
a  host  of  diseases  that  had  previously  resisted  every  other  mode  of  treatment. 
The  same  application  to  the  chest,  when  the  patient  complained  of  chilliness 
in  that  particular  part,  has  materially  aided  me  in  the  treatment  of  many  cases 
of  phthisis.  In  both  instances,  where  heat  was  the  more  general  complaint, 
cold  sponging  has  been  followed  by  an  equally  beneficial  effect. 

The  ingredients  of  plasters,  blisters,  ointments,  lotions,  &c,  what  are  they 
but  combinations  of  the  agents  with  which  we  combat  fever  ?  Their  benefi- 
cial influence  depends  upon  the  change  of  motion  and  temperature  which  they 
produce  by  their  electrical  or  chemical  action  on  the  nerves  of  the  part  to 
which  they  are  directed.  Cantharides  will  not  blister  the  dead — they  have 
very  little  effect  even  on  a  dying  man  !  Every  one  of  the  chrono-thermal 
and  other  agents  may  be  locally  employed  in  certain  cases — sometimes  with 
more  and  sometimes  with  less  advantage  than  when  given  internally. 

Gentlemen,  I  shall  employ  what  remains  of  our  time  to-day  in  a  brief  no- 
tice of  the  doctrines  of  Hahnemann,  the  founder  of  the  Homoeopathic  School. 
His  pamphlet,  entitled,  "  The  Spirit  of  the  Homoeopathic  Doctrine,"  com- 
mences thus  : — "  To  know  the  essence  of  Diseases,  and  the  hidden  changes 
which  they  effect  in  the  body,  is  beyond  the  reach  of  the  human  understand- 
ing."— Which  proposition  he  contradicts  by  the  following  paragraph  :  "  It  is 

*  Two  Swedish  physicians,  Messrs.  Erenhoff,  and  Inde  Bctou,  now  settled  in  London,  successfully 
treat  numerous  chronic  diseases  solely  by  the  use  of  well-directed  mechanical  means. 


174  LECTURE  VIII. 

necessary  that  our  senses  should  be  able  clearly  to  discern  what  it  is  in  each 
malady  which  must  be  removed  in  order  to  restore  health,  and  that  each  medi- 
cine should  express,  in  a  distinct  and  appreciable  manner,  what  it  can  cure 
with  certainty,  before  we  can  be  in  a  condition  to  employ  it  against  any  di- 
sease whatever."  From  this  you  perceive  that  Hahnemann,  like  Dr.  Hol- 
land and  the  humoral  schoolmen,  look  upon  disease  as  a  fanciful  something  to 
be  "  removed,"  instead  of  a  state  to  change  ;  and  as  he  uses  the  phrase,  "  to 
expel  disease  "  in  another  part  of  his  work,  it  is  evident  he  does  not  know  in 
what  Disorder  consists.  Again,  "  The  material  substances  of  which  the  hu- 
man organism  is  composed,  no  longer  follow,  in  their  living  combination,  the 
laws  to  which  matter  is  subject  in  the  state  of  non-life  ;  and  they  acknow- 
ledge only  the  laws  proper  to  vitality — they  are  then  animated  and  living,  as 
the  whole  is  animated  and  living.  In  the  organism  reigns  a  fundamental 
power,  indefinable  yet  every  where  dominant,  which  destroys  every  tendency 
in  the  constituent  parts  of  the  body  to  conform  themselves  to  the  laws  of 
pressure,  of  concussion,  of  vis  inertiee,  of  fermentation,  of  putrefaction,  &c, 
which  subjects  them  exclusively  to  the  wonderful  laws  of  life,  that  is  to  say, 
maintains  them  in  the  state  of  sensibility  and  activity  necessary  to  the  con- 
servation of  the  living  whole — in  a  dynamic,  almost  spiritual  state."  Gentle- 
men, what  is  the  sum  of  all  this  ?  Nothing  more  nor  less  than  that  if  you 
press  the  soft  parts  of  the  body,  they  will  not  yield  to  a  resisting  substance 
— that  you  cannot  be  shaken  by  concussion,  or  have  the  bone  of  the  leg  or 
arm  broken  by  external  agency — that  you  are  in  a  "dynamic  state  " — a  state 
"  almost  spiritual!"  AVhat  is  the  meaning  of  the  word  dynamic?  It  sig- 
nifies "  moving  power."  This  you  can  understand  ;  but  when  our  author, 
apparently  dissatisfied  with  his  own  term,  would  further  explain  it  by  the 
words  "  almost  spiritual,"  a  phrase  perfectly  indefinite,  you  see  he  has  only 
a  vague  conception  that  the  various  parts  of  the  body  are  in  motion.  But 
that  the  material  atoms  of  the  living  frame  do  follow  the  laws  to  which  all 
Matter  is  subject,  under  the  particular  circumstances  in  which  the  matter 
composing  them  is  placed,  is  undoubted.  A  piece  of  amber  or  sealing-wax, 
when  rubbed,  first  attracts  silk,  then  repels  it ;  producing  alternate  motion 
altogether  independent  of  mechanics.  Though  not  Life,  this  phenomenon  is 
at  least,  a  type  of  it;  for  the  organic  and  other  motions  of  an  organism  termed 
Life,  even  in  the  highest  grade  of  animals,  when  analysed,  will  be  found  to 
be  mere  periodic  repetitions  of  alternate  Attraction  and  Repulsion.  What 
are  the  successive  conversion  of  the  food  into  blood,  of  the  blood  into  the 
matter  of  tissue  and  secretions,  but  so  many  instances  illustrative  of  this 
proposition? — what  the  alternate  inspiration  and  expiration  of  the  lungs  ? — 
the  equally  alternate  contraction  and  dilatation  of  the  heart — sleep  and  wake- 
fulness, love  and  hate,  ambition  and  worldly  disgust,  but  so  many  modifica- 
tions or  effects  of  attractive  and  repulsive  influences ! 

When  the  magnet  attracts  iron,  it  does  so,  not  in  contrariety  to  the  law  of 
Gravitation,  but  in  obedience  to  the  more  comprehensive  law  of  which  Gravi- 
tation is  a  part — namely,  Electricity  or  Galvanism.  But  Electricity,  like 
Electrive  Attraction,  is  only  a  fragment  of  the  great  doctrine  of  LIFE.  The 
word  Life,  when  applied  to  animals  in  their  healthy  condition,  is  an  abstract 
term  expressive  of  the  sum  total  of  harmonious  movements  produced  by  the 
principal  forces  in  nature,  when  acting  together  with  perfect  Periodicity,  in 
one  body.  Life,  then,  is  Electricity  in  its  highest  sense,  even  as  the  attrac- 
tion of  gravitation  is  Electricity  in  its  lowest  sense.  The  attraction  of  the 
magnet  is  an  electrical  step  in  advance  of  gravitation, — chemical  change  one 
step  more, — the  alternate  attraction  and  repulsion  of  amber  is  a  still  higher 
link  in  the  electrical  chain,  (ialvanism  and  Electricity,  strictly  so  rail,  d, 
embrace  all  the  subordinate  links,  while  LIFE  or  Vitat.  Elki  tkiuty 
comprehend*  the  whole.  Mere  mechanical  motion,  though  it  belongs  to  all 
animal  life,  in  reality  only  grows  out  of  it.  There  is  no  mechanical  move- 
the  foetal  germ,  nor  is  such  movement  necessary  to  the  life  of  the 


LECTURE   VIII.  175 

plant.  Vital  Electricity,  then,  produces  changesin  every  way  analogous 
to  the  changes  that  take  place  in  inorganic  bodies,  but  not  the  same  changes, 
— for  no  Electricity  short  of  the  highest  or  Vital  kind  can  produce  the  elec- 
trical and  chemical  changes  constantly  going  on  in  a  living  body,  any  more 
than  the  power  of  gravitation  or  the  magnet  could  produce  the  higher  move- 
ments of  common  chemistry.  The  chemist  who,  like  Liebig,  expects  by  the 
destructive  chemical  analysis  of  dead  organs  in  his  laboratory,  to  be  able  to 
produce  or  explain  the  very  opposite  transformations  that  take  place  in  the 
organs  of  the  living,  will  no  more  improve  medicine  than  the  mere  anatomist 
who  separates  them  tissue  by  tissue  with  his  scalpel.  However  similar  his 
chemistry  and  his  electricity  may  be  to  vital  electricity  and  vital  chemistry, 
however  analogous  the  results  of  both  be  to  the  attractive  and  repulsive  mo- 
tions that  constitute  vitality,  yet  are  the  transformations  not  identical, — curi- 
ously resembling  them  certainly,  but  still  so  different  that  they  never  even 
approach  to  organism.  The  electricity  and  chemistry  of  man  no  more  could 
produce  a  worm,  or  a  leaf  even,  than  the  inferior  intellectual  power  of  the 
dog  or  the  elephant  could  produce  the  Iliad.  The  same  harmony  of  motion 
that  we  behold  in  animal  life  we  equally  find  in  the  life  of  the  vegetable  ;  but 
the  forces  employed  are  fewer  in  number,  and  more  feeble  in  their  action. 
The  extremes  of  vegetable  and  animal  life  approach  each  other.  In  the 
zoophyte  or  pilant-ammal  we  have  the  connecting  link  of  both.  Both  are 
made  up  of  inorganic  matter, — metals,  minerals,  air,  earth,  and  every  other 
material  thing  successively  becoming  atomically  organised  and  living  in  their 
turn.  Man,  who  stands  highest  in  the  scale  of  animated  beings,  is  a  micro- 
cosm or  little  world  in  himself;  yet  what  is  he  but  a  Parasite  on  the  globe's 
surface— the  Globe  itself  but  an  Atom  in  the  LIFE  of  the  UNIVERSE! 
But  listen  to  Hahnemann  :  "  The  Life  of  man,  and  its  two  conditions,  Health 
and  Sickness,  cannot  be  explained  by  any  of  the  principles  which  serve  to 
explain  other  objects.  Life  cannot  be  compared  to  any  thing  in  the  world 
except  itself — no  relation  subsists  between  it  and  an  hydraulic  or  other 
machine — a  chemical  operation — a  decomposition  and  production  of  gas,  or  a 
galvanic  battery.  In  a  word,  it  resembles  nothing  which  does  not  live. 
Human  life,  in  no  respect  obeys  laws  which  are  purely  physical,  which  are 
of  force  only  with  inorganic  substances."  We  apprehend,  Gentlemen,  that 
the  whole,  or  nearly  the  whole,  of  this  statement  is  assumption,  and  if  there 
be  truth  in  nature,  that  this  assumption  is  a  fallacy.  If  you  compare  the 
ossification  of  the  skull  with  mechanical  inventions,  you  will  find  it  to  be  an 
exemplification  of  the  most  perfect  carpentry.  The  joints  of  the  body  em- 
brace every  principle  of  the  hinge  ;  the  muscles,  tendons,  and  bones  are  so 
many  ropes,  pulleys,  and  levers  ;  the  lungs  act  in  bellows-fashion,  alternately 
taking  in  and  giving  out  gas  ;  the  intestine  canal  is  a  containing  tube.  Then, 
in  regard  to  the  vascular  system,  the  heart  and  blood-vessels  are  to  a  great 
extent  a  hydraulic  apparatus,  as  you  may  prove,  by  tying  an  artery  or  com- 
pressing a  vein  ;  the  blood,  in  the  first  instance,  being  arrested  in  its  course 
from  the  left  chamber  of  the  heart;  in  the  second,  being  stopped  in  its  pro- 
gress to  the  right  side  of  it.  What  are  assimilation,  secretion,  absorption, 
the  change  of  the  matter  of  one  organ  into  another — of  the  fluids  into  the 
solids,  and  vice  versa,  but  operations  df  vital  chemistry,  and  the  brain  and 
nervous  system  but  the  xito-galvanic  or  vito-electric  apparatus  by  which 
these  operations  are  effected  ?  That  the  human  body  obeys  laws  purely 
physical,  is  still  further  exemplified  by  the  fracture  of  a  bone  or  the  rupture 
of  a  tendon — and  the  reunion  of  both  is  the  result  of  secretion  under  the  in- 
fluence of  this  vital  electricity,  acting  through  the  nerves  supplying  those  parts. 
If,  during  childhood,  the  great  nerve  of  a  limb  be  paralysed,  the  growth  of 
that  limb  becomes  arrested,  not  only  in  its  breadth,  but  length.  The  nerves, 
then,  are  the  moving  powers,  and  if  you  cut  or  divide  them,  neither  a  broken 
bone  nor  a  ruptured  tendon  can  reunite,  so  as  to  become  useful.  And  do  we 
not  see  analogous  effects  tak;::g  place  in  every  kind  of  matter  under  the  in- 


176  LECTURE  VIII. 

fluence  of  the  galvanic  wire  ?  By  that  we  produce  the  decomposition  and 
recomposition  of  bodies — various  changes  of  motion  and  temperature — of  at- 
traction and  repulsion  of  atoms — which,  if  we  break  the  chain  of  the  wire's 
continuity,  immediately  cease  to  take  place,  but  which  recommence  the  mo- 
ment the  wires  are  again  brought  into  contact.  That  a  living  man  cun  in  an 
oven  defy  a  degree  of  heat  that  would  broil  a  piece  of  dead  flesh,  is  perfectly 
true  ;  but  to  what  is  this  owing,  but  to  the  greater  power  of  attraction  which 
the  particles  of  his  body  maintain  to  themselves  in  their  living  than  dead 
state  ?  Nevertheless,  the  degree  of  heat  may  be  so  raised  as  to  decompose 
portions  even  of  the  living  body,  and  finally  reduce  the  whole  to  a  state  in- 
compatible with  life.  And  may  not  the  electric  state  of  all  bodies,  gold  and 
silver  for  example,  be  similarly  influenced  and  altered  ?  How,  then,  can  the 
phenomena  embraced  by  the  term  life  be  said  to  "  resemble  nothing  which 
does  not  live?"  They  resemble  everything  of  which  our  senses  can  take 
cognisance ;  we  can  destroy,  but  we  cannot  imitate  them.  "  There  is  no  agent 
or  power  in  nature,"  says  Hahnemann,  "capable  of  morbidly  affecting  man  in 
health,  which  does  not  at  the  same  time,  possess  the  power  of  curing  certain 
morbid  states."  But  what  is  this  but  another  mode  of  expressing  Shaks- 
peare's  words,  "  In  poison  there  is  physic?"  "Now,"  continues  Hahne- 
mann, "  since  the  power  of  curing  a  disease,  and  that  of  producing  a  morbid 
affection  in  persons  in  health,  are  inseparable  from  each  other  in  all  medicines, 
and  that  these  two  powers  proceed  manifestly  from  one  and  the  same  source, 
that  is  to  say,  from  the  properties  which  medicines  have  of  modifying  dyna- 
mically the  state  of  man  ;  and  that,  consequently,  also,  these  cannot  act  on 
the  diseased  after  any  other  inherent  natural  law  than  that  which  presides 
over  their  action  on  individuals  in  health  ;  it  follows  from  this,  that  the  power 
of  the  medicine  which  cures  the  disease  in  the  sick  is  the  same  as  that  which 
causes  it  to  excite  morbid  symptoms  in  the  healthy."  That  the  strictest 
medicinal  substances  all  kill  and  cure  upon  one  and  the  same  principle,  few 
will  dispute  who  have  listened  to  these  lectures.  But  "the  property  which 
medicines  have  of  modifying  dynamically  the  state  of  man"  is  merely  a  Greek 
expression,  signifying  that  they  possess  a  moving  principle.  In  this  there  is 
nothing  new,  for  Shakspeare,  as  we  have  seen,  said  the  same  thing  in  good 
English  two  centuries  before  Hahnemann  was  born.  In  the  course  of  my 
next  lecture,  Gentlemen,  I  shall  have  the  pleasure  of  demonstrating  to  you 
that_  medicinal  substances  can  only  disturb  the  existing  temperature  "and 
motion  of  any  organ  or  atom  of  the  body,  by  the  electrical  or  galvanic  force 
which  they  exert  upon  it  through  a  nervous  medium.  Of  this  trutli  Shaks- 
peare and  Hahnemann  were  equally  ignorant. 

"  As  soon,"  proceeds  Hahnemann,  "  as  we  have  under  our  eyes  the  table 
of  the  particular  morbid  symptoms  produced  in  a  healthy  man  by  different 
medicinal  substances,  it  only  remains  to  us  to  have  recourse  to  pure  experi- 
ments, which  alone  are  capable  of  determining  what  are  the  medical  symptoms 
(or  the  symptoms  produced  by  the  medicine  in  the  healthy  subject)  which 
always  arrest  and  cure  certain  morbid  symptoms  (?'.  c.  disease.-)  in  a  rapid 
and  durable  manner,  in  order  to  know  beforehand  which  of  those  medicines, 
the  particular  symptoms  of  which  have  been  studied,  is  the  surest  method 
of  cure  in  each  given  case  of  disease." 

So  here  we  have  over  again  the  exploded  doctrine  of  spKCirirs,  or  reme- 
dies "which  always  arrest  and  cure"  certain  morbid  symptoms!  The 
whole  sentence  is  somewhat  confused  and  parenthetical;  but  from  it  and 
other  passages  you  may,  nevertheless,  see  that  while  Hahnemann  obtained 
a  glimpse,  and  a  glimpse  only,  of  the  principle  of  unity  upon  which  remedies 
act,  not  only  was  he  ignorant  of  the  real  nature  of  their  power,  but  alsooftho 
utter  impossibility  of  predicating  in  any  one  case  of  disease,  what  remedy 
would  certainly  achieve  amelioration,  "far  lesa  a  cure.  This  sentence  he 
never  could  have  written,  had  he  known  that  every  medicinal  power, 
a  repulsive  force  in  one  individual  and  an  attractive  force  in  another,  may 


LECTURE  VIII.  177 

act;  inversely  in  any  two  cases  of  the  same  disease.  If  there  be  a  truth  more 
sure  than  another  in  physic,  it  is  this,  that  until  we  have  absolutely  tried  a 
medicinal  agent  in  any  given  case,  we  cannot  possibly  tell  whether  it  .shall 
be  a  remedy  or  an  aggravant  in  that  particular  case.  No,  Gentlemen,  the 
ague-patient  may  come  before  you  ;  but  whether  arsenic  or  bark,  opium  or 
prussic  acid,  shall  arrest  his  disease,  you  can  no  more  with  certainty  predi- 
cate, than  you  can  determine  beforehand  whether  harsh  or  soft  measures,  or 
either,  will  reclaim  a  refractory  child,  or  subdue  an  ungovernable  steed. — 
Trial  and  experience  are  your  only  guides.  This  much,  however,  you  may, 
in  the  majority  of  cases  of  any  given  disease,  predict,  that  such  agents  as  have 
generally  a  definite  power  for  good  or  for  evil  over  definite  parts  of  the  body, 
are  the  class  from  which  you  are  to  expect  most  benefit  in  a  disease  of 
such  parts  ;  but  which  of  them,  the  experience  of  that  case  itself  can  only  tell 
you  ;  for  how  can  you  know  without  such  individual  experience  that  opium 
will  vomit,  rhubarb  excite  epilepsy,  or  ipecacuan  cause  asthma  in  particular 
cases  1  all  of  which  you  are  aware  they  sometimes  do.  When  you  order 
cold  bathing,  can  you  tell  beforehand  whether  your  patient  shall  come  out  all 
in  a  glow,  happy  and  comfortable ;  or  chilly  and  shivering,  and  not  to  be  fem- 
forted  ?  Till  you  can  do  this,  you  cannot  with  certainty  tell  by  what  given 
means  you  are  to  achieve  a  cure  in  any  given  case  of  disease.  So  far  the 
art  of  physic  is,  and  ever  will,  I  fear,  remain  imperfect. 

The  principle  Similia  similibus  curentur,  or  like  cures  like,  which  Hahne- 
mann assumes  as 'his  own  discovery,  was  known  not  only  to  medical  men 
long  before  his  day,  but  was  acted"  upon  by  the  vulgar  time  immemorial. — 
A  passage  which  Shakspeare  puts  in  the  mouth  of  Benvolio  in  Romeo  and 
Juliet,  is  a  proof  that  it  was  practised  at  the  period  he  wrote — 

Tut,  man  !  one  fire  burns  out  another's  burning, 

One  pain  is  lessened  by  another's  anguish ; 
Turn  giddy,  and  be  holped  by  backward  turning, 

One  desperate  grief  cures  with  another's  languish ; 
Take  thou  some  new  infection  to  thine  eye, 
And  the  rank  poison  of  the  old  will  die. 

To  the  same  purpose  he  says  in  Hamlet : — 

Diseases  desperate  grown, 

By  desperate  appliances  are  relieved. 

What  is  all  this  but  similia  similibus  curentur  ?  You  see,  then,  that  Hah- 
nemann, instead  of  being  a  great  discoverer,  as  he  wishes  to  make  out,  is  only 
at  the  most  a  reviver  of  an  old  principle.  Yet  upon  this  principle,  strange  to 
say,  neither  he  nor  his  followers  act !  They  say  one  thing  and  do  another  ; 
for  while  they  declare  their  readiness  to  cure  by  powers  having  precisely 
the  same  action  as  the  causes,  how  can  they  reconcile  with  that  statement 
their  practice  of  treating  grave  disease ;  disease  proceeding  from  a  grave 
agency,  by  the  dissimilar  agency  of  infinitesimal  physic  !  What  is  "  infini- 
tesimal" physic  ?  It  is  the  division  of  a  grain  of  opium,  not  into  quarters,  six- 
teenths, or  sixtieths, — no,  nor  into  hundreds  or  thousands  even, — but  into 
millions  and  ten  millions  !  And  rules  and  regulations  for  its  proper  division 
into  such  parts  are  actually  given  in  homoeopathic  books  !  A  grain  of  opium, 
or  the  common  dose  of  this  drug,  is  to  be  converted,  forsooth,  into  medicinp 
enough  for  ten  thousand  men  ;  and  upon  the  same  principle,  doubtless,  a  loaf 
of  bread  may  be  made  a  dinner  for  an  army  !  Gravely  to  argue  the  case — if 
grave  disease  could  be  caused  by  the  millionth  or  decillionth  part  of  a  grain 
of  our  common  medicinal  substances,  what  apothecary's  apprentice,  who 
must  be  constantly  rubbing,  shaking,  and  inhaling  medicines  in  this  commi- 
nuted state,  could  possibly  enjoy  a  day's  health  ? — and  yet  it  is  by  such  doses 

if  opaque  matter  reduced  to  invisible  minuteness  can  be  termed  such — 

that  diseases  are  to  be  cured  !  Where,  then,  is  the  similarity  of  remedy  to 
cause  in  the  homoeopathic  treatment  ? 


178  LECTURE  VIII. 

In  his  "  Organon,"  Hahnemann  tell  as,  that  almost  all  chronic  diseases  are 
the  result  of  a  morbific  miasm,  which  he  calls  the  Psoric,  or  the  itch  prin- 
ciple ;  and  this,  he  says,  and  two  other  evil  miasms,  the  Syphilitic  and  the 
Scrofulous,  may  be  looked  upon  as  the  parents  of  all  the  diseases  of  man! 
Men;  phantoms,  Gentlemen,  of  an  excited  imagination  ;  mere  crotchets  of  a 
mind  clouded  with  the  ghosts  and  goblins  of  those  nurseries  for  grown-up 
children — the  German  universities.  Of  his  utter  ignorance  of  the  true  mo- 
tions and  changes  of  the  organic  matter  of  the  body,  whether  in  health  or  dis- 
ease, and  of  the  thousand  morbific  causes  visible  and  invisible  that  daily  occur 
in  life,  there  could  be  no  greater  proof  than  this  announcement ;  you  who  are 
no  longer  in  the  dark  have  only  to  hold  up  the  torch  of  truth  to  dash  his  day- 
dream to  the  dust ! 

When  I  first  heard  of  the  homoeopathic  doctrine  of  infinitesimal  physic,  I 
felt  tempted  to  believe  that  the  whole  was  a  weak  invention  of  those  enemies 
to  medical  truth,  the  medical  reviewers — knowing,  as  I  do,  the  trickery  and 
misrepresentation  in  which  these  gentry -indulge,  when  acting  on  behalf  of 
the  professional  tradesmen  whose  mercenaries  they  are.  His  own  volume 
hasf  however,  undeceived  me;  his  own  Organon  develops  the  number  of 
shakes  and  rubs  by  which  the  millionth  part  of  a  grain  of  quinine  may  be- 
come one  of  the  deadliest  poisons,  and  the  ten  millionth  part  of  a  grain  of 
opium,  a  medicine  to  cause  you  to  sleep  your  last  sleep  !  But  Hahnemann 
is  a  disciple  of  Mesmer  ;  and  he  tells  you  to  watch  the  miracles  effected  by 
animal  magnetism.  Do  that,  he  says,  and  you  will  no  longer  doubt  the  cures 
which  may  be  achieved  by  infinitesimal  physic.  Now,  so  perfectly  ready 
am  I  to  believe  what  he  or  his  disciples  may  tell  me  upon  this  point,  that  it 
is  a  medical  maxim  of  mine,  "  Anything  may  do  anything,  and  anything  may 
not  do  anything,"  according  to  the  ignorance  and  credulity  of  the  patient,  i< 
it  be  a  charm  ;"or  according  to  the  constitution  and  exigencies  of  the  case,  if 
it  be  a  physical  agent.  In  which  light  infinitesimal  physic  is  to  be  viewed, 
you,  Gentlemen,  may  decide  at  your  leisure. 

What  but  faith  or  a  fancy  to  try  could  induce  people  to  put  themselves 
under  the  hands  of  a  homoeopathic  practitioner  ?  The  influence  which  confi- 
dence, simply,  may  produce  on  the  body,  we  have  proved  by  what  took  place 
at  Breda,  in  1625.  During  the  siege  of  that  city,  three  or  four  drops  of  a 
hocuspocus  medicine  were  said  to  be  sufficiently  powerful  to  impart  a  healing 
virtue  to  a  gallon  of  water  !  The  thing  was  believed,  and  the  sick  immedi- 
ately took  up  their  beds  and  walked.  To  tell  the  sensible  part  of  mankind 
that  you  can  cure  any  disea.se  with  the  millionth  or  decillionth  part  of  a  grain 
of  opium,  bark,  or  aconite,  would  only  excite  their  ridicule;  but  you  know 
how  little  will  influence  the  minds  of  the  multitude,  who,  being  ignorant,  are 
naturally  weak  and  credulous.  You  remember  what  I  told  you  at  my  last 
lecture.  The  same  reparative  power  of  nature  by  which  a  cut  finger  is 
healed,  will  cure  nineteeen  out  of  twenty  cases  of  most  diseases,  without  the 
assistance  of  any  physic  at  all.  Such  cases,  when  treated  kormvopath- 
ically,  that  is,  with  hope  and  humbug,  are  of  course  set  down  as  wonderful 
cures;  and  wonderful  they  are,  indeed,  when  compared  with  the  results  of 
the  apothecary  system — a  system  by  which  every  similar  disorder,  for  the 
most  part,  is  aggravated  through  the  interference  of  the  routinists,  who,  partly 
by  playing  on  the  fears  of  the  patient,  and  partly  by  making  his  stomach  an 
apothecary's  shop,  generally  contrive  to  prolong  the  case  so  long  aa  the  -nl>- 
ject  of  it  will  continue  to  act  according  to  their  rules.  Here  the  homoeopathic 
doctor  may  safely  retort  on  the  old  practitioner.  With  the  mass  of  mankind 
the  homoopathist  has  only  to  affect  a  superior  knowledge  of  the  visible  and 
invisible  world,  speak  confidently  of  the  cures,  real  or  supposed,  effected  by 
his  treatment,  and  talk  mysteriously  of  the  rubs  and  shakes  by  which  he  im- 
parts a  magical  or  magnetic  virtue  to  his  infinitesimal  physic.  Should  a  doubt 
remain,  be  may  bant  at  the  wonders  sf  Kleciricin  or  Galvanism;  for  ; 
mixture  of  truth  will  make  his  mummery  go  down   better— just   ns  a  little 


LECTURE  IX.  179 

apparent  candour  will  make  you  more  readily  give  credence  to  a  calumny  or 
a  scandal.  In  both  cases  a  complete  want  of  principle  is  the  chief  element 
of  success  on  the  part  of  the  impostor — and  faith  the  weakness  or  strength  of 
the  dupe.  If  the  former  only  get  the  latter  to  listen  to  him,  he  may  inoculate 
him  with  a  fancy  to  try — that  of  itself  implies  faith.  However  small  at  first, 
it  will  be  sure  to  increase  by  thinking  and  talking  about  the  new  method.  A 
little  opposition  is  a  good  thing  sometimes — the  patient  gets  heated  up  by  it. 
If  he  has  a  tendency  to  improve,  he  will  improve  the  faster — if  he  finds  him- 
self deceived,  he  will  conceal  the  fact,  as  he  would  be  sorry  that  others  should 
not  be  as  great  fools  as  himself.  Patients  of  the  class  who  consult  Homceo- 
pathic  practitioners,  generally  collect  together,  talk,  discuss,  and  theorise  till 
they  work  themselves  into  a  kind  of  Fever — such  fever,  or  rage,  by  exciting 
and  animating  them,  will,  in  many  cases,  be  infinitely  more  beneficial  to  their 
constitution,  than  the  draughts  and  mixtures  usually  inflicted, — not,  remark, 
so  much  on  account  of  the  necessities  of  the  patient  as  the  needy  condition  of 
the  routine  practitioner.  Having  once  become  partizans  and  disciples,  they 
next  find  a  pleasure  in  making  converts.  With  this  object  before  them,  they 
work  body  and  mind  in  the  cause.  Can  you  wonder  they  should,  in  many 
cases,  get  well  by  the  new  mode  of  life  to  which  they  have  taken  ?  This, 
Gentlemen,  is  the  secret  of  any  success  obtained  in  the  course  of  the  Homoeo- 
pathic treatment.  Like  the  French  "medicine  expectante,"  it  is  a  system 
of  placebo.  What  is  new  in  it  is  not  true  ;  what  is  true  is  not  new.  Savage 
Landor  says  rightly,  "  most  disputants  drive  by  truth  or  over  it."  In  the 
case  of  similia  similibus,  Hahnemann  has  done  both — he  adopts  it  as  his 
motto,  but  practises  on  a  principle  the  reverse.  What  does  it  mean  ?  Power 
opposes  power.  Did  we  require  to  be  told  this  by  Hahnemann  ?  The  doc- 
trine, Like  cures  like,  was  so  obvious  as  to  be  a  popular  axiom  in  every  age 
— but  it  is  only  the  minor  of  a  major  proposition,  a  fragment  of  the  great  Ab- 
stract Law ANT  GIVEN  POWER  APPLIED  IN  A  PARTICULAR  DEGREE  AND  AT 

PARTICULAR  PERIODS  MAT  CAUSE,  CURE,  AGGRAVATE,  OR  ALLEVIATE  ANT 
GIVEN  FORM  OF  DISEASE,  ACCORDING  TO  THE  CONSTITUTION  OF  THE  PAR- 
TICULAR PATIENT. 

[On  the  publication  of  the  first  edition  of  this  work,  the  Homceopathists 
accused  me  of  not  understanding  their  principles.  My  answer  to  that  was, 
that  I  had  at  least  read  their  own  books,  and  if  I  was  such  a  fool  as  not  to 
be  able  to  understand  their  writings,  they  were  greater  fools  not  to  write  more 
intelligibly. 

"  Your  true  rao-meaning  puzzles  more  than  sense  !" 
Since  the  publication  of  the  second  edition  they  have  changed  their  tune,  and 
say  I  have  borrowed  from  Hahnemann — to  which  I  reply — rich  men  seldom 
borrow,  and  never  steal.  If  the  homceopathists  will  be  so  good  as  to  put  in 
print  the  instances  in  which  I  have  neglected  to  acknowledge  anything  I  have 
borrowed  from  them  or  others,  I  will  very  much  thank  them  for  reminding 
me  of  what  is  right.] 


LECTURE   IX. 

PHTSIC  AND  POISON  IDENTICAL — REMEDIAL  MEANS  INCLUDE  EVERT  THING 
IN  NATURE — ACTION  OF  MEDICINAL  SUBSTANCES  PROVED  TO  BE  ELEC- 
TRICAL— PARTICULAR  REMEDIES,  AND  WHT  THET  AFFECT  PARTICULAR 
PARTS. 

Gentlemen, 

From  the  History  of  Medicine  we  learn,  that  after  Charms 
cajae  Simples.  To  the  list  of  our  remedial  means,  chance  and  experience 
successively  added  Poisons.    "Wherefore,"  asked  Pliny,  "has  our  mother, 


180  LECTURE  IX. 

the  Earth,  brought  forth  so  many  deadly  drugs,  but  that,  when  wearied  with 
suffering,  we  may  employ  them  for  suicide  ?"  If  such  was  the  opinion  of  the 
polished  Roman,  can  yon  wonder  at  the  belief  of  the  rude  Carib,  and  the  still 
ruder  Boschman,  that  poisons  were  sent  them  for  the  destruction  of  their 
national  enemies  ?  The  friends  of  the  Chrono-Thermal  System  see  the  matter 
in  another  light.  In  common  with  the  believers  of  the  Christian  creed,  they 
assume,  that  the  beneficent  Creator  of  all  things  sent  nothing  into  the  world 
for  the  destruction  of  his  creatures.  By  the  motion  of  men's  hands  the 
Pyramids  were  produced.  The  same  motion,  acting  reversely,  might  make 
them  vanish  from  the  plains  where  they  have  stood  the  wonder  of  centuries. 
If  the  identical  power,  then,  which  may  render  a  temple  or  a  tower  a  heap 
of  ruins,  applied  in  another  fashion  to  the  materials  composing  it,  first  erected 
the  fabric — why  may  not  the  motive  power  of  a  physical  agent,  which,  wrong- 
ly administered,  has  destroyed  the  life  of  man,  be  employed,  in  a  right  direc- 
tion, to  preserve  his  existence? 

"  Philosophy,  wisdom,  and  liberty,  support  each  other ; — he  who  will  not 
reason  is  a  bigot — he  who  cannot  is  a  fool — and  he  who  dares  not  is  a  slave. !" 
— [Sir  William  Drummond.]  The  base  and  selfish,  of  all  ages,  have  ruled 
mankind  by  terror.  By  this  the  priest  has  trampled  down  reason  ;  the  despot, 
the  rights  of  a  people.  To  this  passion  the  charlatan  appeals,  when  he 
sneeringly  speaks  of  particular  substances  as  poisons,  the  better  to  distinguish 
them  from  his  own  nostrum  of  universal  and  absolute  safety  !  What  is  the 
real  meaning  of  the  word  poison  ?  In  its  popular  sense,  it  signifies  anything 
in  nature,  that,  in  a  comparatively  small  quantity,  can  shorten,  or  otherwise 
prove  injurious  to  life.  It  is,  then,  a  term  of  relation — a  term  depending  en- 
tirely on  degree,  volume,  or  scale.  But  what  is  there  under  heaven,  when 
tried  by  this  test,  that  may  not  become  a  poison  ?  Food — fire — water — air 
— are  these  absolutely  innocuous?  The  glutton  dies  of  the  meal  that 
gorged  him  ;  is  that  a  reason  why  we  should  never  eat  ?  The  child  is  acciden- 
tally involved  in  the  flames  of  a  furnace ;  must  we,  on  that-  account,  deny 
ourselves  the  warmth  of  the  winter-hearth  ?  Air  has  chilled,  and  water 
drowned;  must  we,  therefore,  abandon  air  and  water?  Yet,  this  is  the 
mode  in  which  certain  wiseacres  reason  on  medicine  !  We  must  cease,  ac- 
cording to  these  praters,  to  use  opium  medicinally — opium  which,  in  one 
degree,  has  so  often  given  relief  to  suffering;  because  the  suicide,  in  another, 
has  settled  his  earthly  account  with  it !  We  must  repudiate  the  curative 
effects  of  arsenic  in  Ague;  because,  with  a  thousand  times  the  quantity 
adequate  to  that  desirable  end,  the  cut-throat  and  the  poisoner  have  de- 
spatched their  victims  by  arsenic  !  We  must  linger  life  away  in  the  agonies 
of  gout  and  rheumatism,  instead  of  resorting  to  colchicum,  which  has  so  often 
cured  both:  because  people  have  been  accidentally  destroyed  by  colchicura 
in  a  volume  never  given  for  either  of  these  diseases  !  How  many  distressing 
complaints  has  not  prussic  acid  cured  or  alleviated  :  yet.  we  must  abjure  its 
benign  influence  in  this  way,  forsooth  ;  because  love-sick  maidens,  and  men 
maddened  by  misfortune,  have  ended  their  lives  with  prussic  acid,  in  a 
quantity  which  nobody  ever  dreamt  of  giving  for  any  disease  whatever!  By 
the  same  enlightened  Philosophy,  we  must  not  pat  a  child's  head,  because  a 
blow  might  knock  it  down  !  Gentlemen,  need  I  tell  you,  thai,  the  whole  of 
these  agents,  in  their  medicinal  doses,  are  as  safe  as  rhubarb  in  its  medicinal 
dose;  and  safer  than  wine  to  some  people,  in  the  quantity  usually  taken  at 
table?  But  granting  that,  even  in  their  medicinal  doses,  each  and  all  of  these 
substances,  in  common  with  everything  in  existence,  occasionally  produce 
the  temporary  inconvenience  of  disagreeable  feeling, — is  that  any  reason  why 
we  should  abandon  their  use,  in  the  cure  of  diseases  attended  with  reelings 
for  the  most  part  more  sensibly  disagreeable !  What  on  earth,  worth  ac- 
complishing, was  ever  accomplished  without  a  similar  risk  ?  We  cannot 
cross  a  thoroughfare  without  the  risk  of  being  jostled-  -ergo,  we  must  never 
cross  a  thoroughfare!     Gentlemen,  ubi  rims  ibi  virtus,  is  as   true  in  most 


LECTURE  Ifc.  l81 

things  as  in  medicine.  Poison  and  Physic  are,  in  truth,  one  and  identical, 
for  any  earthly  agent  may  become  both,  by  turns,  according  as  it  is  used  or 
abused.     A  German  poet  rightly  observes — 

Divide  the  thunder  into  single  notes, 
And  it  is  but  a  lullaby  for  children; 
But,  pour  it  in  one  volume  on  the  air, 
And  the  intensity  makes  heaven  to  shake. 

The  same  rule  holds  good  in  physic.  Everything  depends  on  the  scale  or 
degree  in  which  you  apply  a  given  substance  to  the  body,  and  the  particular 
circumstances  and  condition  of  the  body  at  the  time,  whether  such  substance 
be  a  remedy  or  a  poison.  What  is  there  that  pertains  to  earth  or  air,  that 
we  may  not  usefully  employ  ?  If  man,  in  his  ignorance  or  depravity,  turn  a 
particular  power  to  evil  account  instead  of  to  good,  shall  blame  be  imputed 
to  the  Almighty,  who  bestowed  it  on  him  as  a  boon  ?  Let  babblers  beware 
how  they  commit  themselves  in  this  matter  ;  let  them  fully  understand,  that 
when  they  decry  any  agent  in  nature  as  being,  in  the  abstract,  a  dangerous 
medicine,  or  a  poison,  they  not  only  arraign  God  for  his  goodness,  but  expose, 
at  the  same  time,  their  utter  ignorance  of  bis  laws.  Where  men  have  not 
examined,  surely  it  were  only  policy  to  be  silent.  Do  medical  practitioners 
ever  prate  in  this  language  of  imbecility  ?  Too  frequently,  Gentlemen  ;'  but 
in  their  case,  it  generally  proceeds  less  from  a  want  of  knowledge  of  the  sub- 
ject, than 'from  a  wish  to  disparage  a  professional  competitor.  Sordid  prac- 
titioners know  that  there  is  no  readier  mode  of  influencing  the  sick,  than  by 
playing  upon  their  fears.  Not  a  week  passes,  but  I  am  told  by  some  patient 
— "  Oh,  I  showed  your  prescription  to  Dr.  So-and-so,  and  he  said  it.  con- 
tains poison  /"  Bless  my  life  !  I  generally  answer,  what  a  wonderful  thing ! 
Why,  then,  does  not  Dr.  So-and-so  get  the  College  of  Physicians  indicted  for 
the  introduction  of  such  substances  into  their  medicinal  pharmacopeia  ?  Why 
does  he  not  gravely  arraign  them  for  the  processes  which  they  have  devised 
for  the  preparation  of  "  medicinal"  arsenic,  "medicinal"  opium,  "  medicinal" 
prussic  acid,  and  tell  them  boldly  and  at  once  that  these  are  all  so  many  con- 
centrated essences  of  death  and  destruction,  which  no  skill  can  render  valu- 
able, no  scale  of  diminution  adapt  to  the  relief  or  cure  of  their  suffering 
fellow-creatures  ?  Only  let  Dr.  So-and-so  put  down,  in  writing,  that  any  of 
these  substances  ever  poisoned  any  body,  in  the  dose  and  at  the  age  for  which 
I  and  others  prescribe  it,  and  I  shall  have  the  pleasure  of  publishing  the 
fact  (!)  to  the  professional  world,  for  their  future  edification.  To  whisper 
away  an  honourable  man's  reputation  in  a  corner  where  he  has  no  opportu- 
nity of  reply,  though  a  pitiful  thing  to  do,  is  nevertheless  a  thing  very  often 
and  very  successfully  done  ;  to  write  or  reason  down  the  same  man's  cha- 
racter unfairly,  on  paper,  is  more  difficult.  Cautions,  doubts,  insinuations, 
these  are  the  weapons  by  which  yott  will  be  secretly  supplanted  in  practice. 
Yes,  Gentlemen,  individuals  who  call  themselves  physicians,  and  who,  with- 
out a  scruple,  would  pour  out  a  pint  of  your  heart's  blood  at  a  time,  will 
affect  to  start  at  the  sixteenth  part  of  a  grain  of  strychnine,  and  shrug  their 
shoulders  significantly,  at  two  drops  of  prussic  acid  !  '»  How  easy  to  put 
such  men  down  !"  I  have  been  told.  "  You  have  only  to  ask  them,  if  they 
ever  knew  an  adult  die  of  either  medicine  in  these  doses  ?  and  dare  them  to 
say,  that  they  have  not  themselves  killed  hundreds,  by  taking  away  a  less 
quantity  of  blood  than  a  pint  !"  Both  of  these  I  have  certainly  done — but 
cui  bono?  Reason  ,and  sense  were  on  my  side,  it  is  true  !  but  what  will 
reason  and  sense  avail  him  who  stands,  as  I  stand,  alone — when  his  enemies 
have  a  party  to  back  them,  with  the  patients'  prejudices  and  fears  in  their 
favour  besides  ?  The  practitioners  of  whom  I  speak,  are  all  so  many  links 
of  an  extensive  chain  of  secret  and  systematic  collusion  ;  they  are  all  bound 
to  support  and  keep  by  each  other  ;  they  have  signs  and  counter-signs,  and 
a  common  story  to  tell  :  these  men,  like  false  dicers,  do  deeds  "  never  dreamt 
of  in  your  philosophy."     In  a  word,  so  far  as  medicine  and  medical  practice 


182  LECTURE  IX. 

are  concerned,  the  English  public  are,  at  this  moment,  very  much  in  the  <ame 
blissful  state  of  ignorance  as  the  Emperor  Constantine  was  with  the  doings 
of  his  guards.  "  But  still,  but  still,"  said  Sebastes  of  Mytilene,  "  were  the 
Emperor  to  discover — "  "  Ass !"  replied  Harpax,  "he  cannot  discover,  if 
he  had  all  the  eyes  of  Argus's  tail !  Here  are  twelve  of  us,  sworn,  accord- 
ing to  the  rules  of  our  watch,  to  abide  in  the  same  story." — [Count  Robert, 
of  Paris.]  If  such,  and  similarly  constituted,  be  the  medical  coteries  of 
England,  what  honourable  physician  can  hope  to  rise  in  his  profession  until 
the  eyes  of  the  public  be  opened  1  Sir  James  Mackintosh  was  not  the  only 
man  of  talent  who  left  it  in  disgust.  Locke,  Crabbe,  Sir  Humphrey  Davy, 
Lord  Langsdale  (now  Master  of  the  Rolls),  and  hundreds  of  others,  have 
done  the  same.  Depend  upon  it,  in  these  days,  it  is  only  the  quack  and  the 
unprincipled  practitioner  who  make  fortunes  by  physic. 

But  to  return  to  medicine  and  their  doses.  What  substance  in  the  Mate- 
ria Medica  would  be  worth  a  rush,  if  it  were  absolutely  innocuous  in  every 
dose  and  degree  1  You  all  know  that  rhubarb  and  magnesia  may  each  be 
given  medicinally,  to  the  extent  of  many  grains;  but,  may  not  both  be  so 
advanced  in  the  scale  of  quantity,  as  to  become  equally  fatal  as  strychnine 
or  arsenic,  were  strychnine  or  arsenic  to  be  taken  in  the  usual  dose  of  rhu- 
barb or  magnesia  ?  May  not  our  deadliest  drugs,  on  the  other  hand,  be  so 
reduced  in  volume  as  to  become  as  innocuous,  to  an  adult  at  least,  as  a  grain 
of  rhubarb  would  be  to  an  infant  ?  Surely,  there  is  not  one  of  you,  whether 
sick  or  well,  who  would  object  to  an  infinitesimal  dose  of  arsenic — the  mil- 
lionth or  decillionth  part  of  a  grain,  for  example  !  Ah  !  these  homo?opath- 
ists  1  I  question  if  they  always  keep  to  such  doses ;  for,  when  a  man  makes 
up  his  own  medicines,  he  may  gull  his  patients  as  he  pleases.  But,  be  that 
as  it  may,  there  can  be  no  surer  test  of  imposture,  than  to  be  told  you  may 
take  any  medicine  in  any  quantity.  Can  food  itself  be  thus  taken  ?  If  it 
could,  where  would  be  the  necessity  of  cautioning  gluttons  about  their  diet  ? 
In  truth,  you  can  scarcely  mention  any  one  edible  substance  that  will  agree, 
even  in  a  moderate  quantity,  with  all  patients.  One  person  cannot  eat 
oysters,  without  becoming  the  subject  of  a  rash.  Another,  the  moment  be 
eats  poultry  or  veal,  gets  sick  at  stomach,  though  mutton  and  beef  have  no 
such  effect  on  him.  See,  then,  the  truth  of  the  old  proverb,  "  What  is  one 
man's  meat  is  another  man's  poison.'''  Chesterfield  says,  it  is  vulgar  to  quote 
proverbs  ;  but  Chesterfield  was  a  lord,  and  a  man  of  fashion  ;  and  as  I  have 
no  ambition  to  be  either,  you  will  pardon  me  for  preferring,  with  Cervantes, 
to  strengthen  mv  argument  with  their  pith  and  point — not  only  because  there 
is  no  proverb  that  is  not  true,  but,  because  they  are  all  sentences  drawn 
from  experience,  the  mother  of  the  sciences. 

In  further  illustration  of  this  subject,  I  pass  to  the  lower  animals  ;  and  here 
again  you  will  find  that  no  earthly  agent  has  been  given  us  for  absolute  evil, 
inasmuch  as  substances  which,  in  comparatively  small  quantities,  may  poison 
one  class  of  beings,  are  food  to  another,  in  a  volume  comparatively  large. — 
The  sweet  almond,  for  example,  so  nutritious  to  man,  is  deleterious  to  tfie 
fox,  the  dog,  and  domestic  fowl.  The  hog  may  be  poisoned  by  pepper,  the 
parrot  by  parsley ;  stramonium,  or  thorn-apple,  which,  when  we  prescribe  it 
in  physic,  we  do  cautiously,  and  in  small  quantities,  is  greedily  devoured  by 
the  pheasant  with  impunity  ;  fowls  enjoy  the  darnel  ;  hogs,  the  deadly  night- 
shade. The  water  hemlock,  which  is  poison  to  all  three,  in  common  with 
man,  is  a  most  nutritious  food  to  the  stork,  sheep,  and  goat.  And  the  wolf 
is  reported  to  take  without  inconvenience,  a  quantity  of  arsenic  which  would 
destroy  the  horse.  You  see,  then,  how  completely  the  word  poison  is  a 
term  of  relation. 

The  infinity  of  substances  which  have  been  successfully  applied  to  reme- 
dial purposes,  whether  derived  frojn  the  animal,  vegetable,  or  mineral  king- 
dom, like  the  various  causes  of  the  diseases  for  which  We  administer  them, 
will  all,  upon  investigation,  be  found  to  have  the  most  perfect  unity  in  their 


LECTURE  IX.  183 

mode  of  action.  Their  influence  relates  solely  to  their  motive  power,  differ- 
ing from  each  other,  where  they  do  differ,  merely  in  their  capability  of 
changing,  in  this  way,  the  atomic  relations  of  a  particular  locality  or  tissue 
rather  than  another  ;  but  in  no  other  way  presenting  a  doubt  or  difficulty  as 
to  their  modus  operandi.  What  John  Hunter  said  of  poisons,  applies  of 
course  to  remedies  ;  they  take  their  place  in  the  body  as  if  allotted  to  them." 
Thus,  mercury  and  iodine,  in  whatever  manner  introduced  into  the  system, 
will  still  manifest  their  action,  chiefly  by  changes  in  the  motion  of  the  glands  and 
their  secretions  ;  while  strychnine  and  brucine,  on  the  other  hand,  will  as 
constantly  produce  their  effects  on  the  motive  condition  of  the  muscles. — 
Through  the  medium  of  the  nerves  of  a  part,  the  greater  number  of  medicinal 
substances,  even  when  directly  introduced  into  the  veins,  will  produce  their 
particular  effects,  good  or  bad,  according  to  circumstances,  upon  that  part. — 
When  thus  administered,  antimony  will  prove  equally  emetic,  as  when  intro- 
duced into  the  stomach,  rhubarb  equally  purgative,  and  opium  as  certainly 
soporific.  Is  not  this  the  best  of  all  proofs,  how  surely  these  agents  were 
intended  by  the  Deity  for  the  use  of  man  ? 

If  you  ask  a  teacher  of  medicine,  why  opium  sets  you  to  sleep,  his  answer 
will  be — "  from  its  Narcotic  power.'"  What  can  be  more  satisfactory  ? 
Nineteen  out  of  twenty  students  at  least,  are  satisfied  with  it — they  are  de- 
lighted when  told  in  Greek,  that  it  does  set  them  to  sleep  !  Why  does  Rhu- 
barb purge  ?  "  From  its  Cathartic  power,"  you  will  be  told ;  what  does  that 
mean  ?  simply  that  it  purges  !  Again  you  demand  how  does  antimony  vomit 
— again  you  get  the  Greek  reply,  "  from  its  Emetic  power ;"  in  plain  English, 
it  vomits  !  Such  is  the  mode  in  which  the  schoolmen  juggle  :  instead  of  an 
answer  they  give  you  an  echo  !  Had  these  logomachists — these  word- 
mongers,  been  as  well  acquainted  with  the  motions  of  living  things  as  with 
the  inflections  of  dead  languages,  and  the  anatomy  of  dead  bodies,  they  would 
long  ago  have  preferred  reasoning  to  mystification.  But  for  the  last  ten  cen- 
turies, at  least,  Professors  have  been  doing  little  else  but  splitting  straws, 
blowing  bubbles,  and  giving  a  mighty  great  degree  of  gravity  to  feathers  ! 
Yes,  Gentlemen — 

in  the  same  dull  round  we  see  them  creep, 

Profoundly  trifling — profitlessly  deep, 

Treading  the  paths  their  sires  before  them  trod — 

The  Past  their  heaven — Antiquity  their  God  ! 
We  shall  endeavour  to  develope  what  their  answers  show  they  are  utterly 
ignorant  of — the  Unity  of  Action  of  all  Remedies. 

What  are  the  Forces  which,  by  their  harmonious  movement  in  a  material 
body,  make  the  sum  total  of  the  economy  of  the  life  of  that  body  ?  Vital 
chemistry,  vital  electricity,  vital  magnetism,  vital  mechanics.  By  these 
Forces  are  all  the  Internal  movements  of  man  periodically  produced,  and  by 
the  analogous  External  Forces  only,  can  the  material  of  all  animal  life  be 
sustained  and  otherwise  influenced  from  without.  When  rightly  considered, 
every  force  in  nature  will  be  found  to  resolve  itself  into  a  cause  of  motion 
simply — motion  forward,  or  motion  backward — motion  outward,  or  motion 
inward.  Chemistry,  Electricity,  Magnetism,  Mechanics,  can  each  of  them 
do  no  more  than,  by  their  Attractive  Force,  bring  things  or  their  atoms  into 
closer  proximity  ;  or  place  them  by  the  Force  of  Repulsion,  at  a  greater  dis- 
tance from  each  other.  Attraction  and  Repulsion,  then,  are  the  two  grand 
Forces  by  which,  not  the  motions  of  Man  only,  but  the  motions  of  the  Uni- 
verse are  kept  in  control ;  and  by  these  Forces,  and  no  other,  can  animal  life 
be  influenced  either  for  good  or  for  evil,  whatever  be  the  nature  of  the  mate- 
rial agent  by  which  they  may  be  called  into  play. 

Remedial  Means 

may  include  every  description  of  Force  :  The  Bandage,  Splint,  and  Tooth- 
forceps  are  familiar  examples  of  the  Mechanical  kind;  while  to  Chemistry, 


184  LECTURE  IX. 

among  other  things,  medical  men  owe  the  Alkalis  and  Earths  tbey  use  as 
palliatives  in  the  treatment  of  Acidity  nf'the  stomach.  But  the  purely  Me- 
dicinal agentp — what  ia  the  mode'  of  action  of  these?  How  do  Opium, 
Strychnine,  Arsenic,  and  Prussic  Acid  act  ?  Chemically  it  cannot  be. — for 
they  produce  no  chemical  change, — no  visible  decomposition  of  the  various 
parts  of  the  body  over  which  they  exert  their  respective  influences.  What, 
then,  is  their  action  ?  no  man  in  his  senses  would  suppose  it  to  be  Mechani- 
cal. One  of  two  things  it  must  be,  then,  Electrical  or  Magnetic — for  these 
arc  the  only  other  forces  in  nature  to  which  we  can  apply  for  an  explanation. 
But.  Gentlemen,  are  not  these  two  Forces  One  ?  nay,  under  the  term,  Elec- 
tricity, do  not  practical  philosophers  include  Chemistry  also?  No  person 
in  the  least  conversant  with  the  physical  sciences  would  now  dispute,  what 
Mr.  Faraday  was  the  first  to  prove,  that  all  three  are  in  reality  mere  modifi- 
cations of  one  great  source  of  power.  For,  not  only  can  the  Electrical  Force 
be  so  managed  as  to  produce  Attraction  and  Repulsion  in  all  bodies,  without 
in  any  way  altering  their  constituent  nature  ;  but  it  can  also,  in  most  cases, 
be  so  applied  te  every  compound  body  as  to  cause  a  true  chemical  decompo- 
sition of  its  ultimate  principles.  By  the  same  universal  tower  we  can 
either  make  iron  magnetic,  or  deprive  it  of  the  magnetic  virtue.  We  can, 
moreover,  reverse  by  its  means  the  polarity  of  the  needle  of  a  ship's  compass. 
Is  Electricity,  then,  the  source  of  Meaicinal  agency — the  source  of  power  by 
which  opium  and  arsenic  kill  and  cure  ?  Before  this  question  can  be  satis- 
factorily answered,  we  must  first  know  the  effect  of  the  direct  application  of 
Electricity  to  animal  life.  What  is  its  action  when  directly  applied  to  living 
man  ?  Gentlemen,  it  has  caused,  cured,  and  aggravated  almost  every  dis- 
ease you  can  name, — whether  it  has  come  in  the  shape  of  the  thunder-storm, 
or  been  artificially  induced  by  the  far  less  energetic  combinations  of  human 
invention.  If,  as  in  the  case  of  the  magnetic  phenomena,  it  can  produce, 
takeaway,  and  reverse  the  polarity  or  motive  power  of  the  needle;  so  also 
can  it  give,  take  away,  and  reverse  every  one  of  the  particular  functional  motions 
of  the  various  parts  of  the  living  body  to  which  it  may,  under  particular  circum- 
stances, be  applied.  It  has  cured  palsy,  and  caused  it  also;  but  has  not 
strychnia  done  the  same  ?  In  common  with  arsenic,  it  has  made  the  stout- 
est and  bravest  shake  in  every  limb  :  and,  like  the  same  agent,  it  has  cured 
the  ague.  In  what,  then,  does  its  action  differ  from  arsenic  here  ?  If  it  has 
set  one  man  to  sleep  and  kept  another  wakeful,  opium  has  done  both.  Elec- 
tricity has  cured  cramp  and  caused  it ;  so  have  prussic  acid  and  nitrate  of 
silver.  Do  we  not  prove,  then,  beyond  the  possibility  of  question,  that  the 
action  of  these  Medicinal  substances  is  purely  Electrical?  By  precisely  the 
same  power,  mercury  salivates,  antimony  vomits,  and  rhubarb  purges.  By 
the  very  same  power  they  may  all  produce  reverse  effects.  The  primitive 
agency  of  the  purely  Medicinal  substances,  then,  is  one  and  the  same, — 
namely,  the  power  of  Electrically  moving  the  body  in  some  of  its  various 
parts  or  atoms,  inwards  or  outwards,  according  to  the  previous  state  bf  the 
Vital  Electricity  of  the  Brain  of  the  different  individuals  to  whom  they  may 
be  administered.  For,  through  the  medium  of  the  Brain  and  Nerves,  do  all 
such  substances  primarily  act.  The  ultimate  and  apparently  unlike  results 
of  the  action  of  different  substances  depend  entirely  on  the  apparent  dissimilarity 
of  the  functions  of  the  organs  they  respectively  influence.  As  already 
stated,  the  temperature  of  the  part  or  organ  of  a  livinjj;  body  thus  mulivtly  in- 
fluenced, becomes  in  every  case  correspondingly  altered.  If  it  lie  asked  in 
what  manner  opium  or  antimony  can  alter  the  temperature  or  motion  of  any 
organ  through  its  nerves,  I  can  only  refer  to  the  analogous  changes  which 
take  place  in  chemistry,  through  the  medium  of  tin:  Electric  chain  or  Q»l- 
vanic  wire.  When  acted  upon  by  either,  bodies  which  were  previously 
cold  become  instantaneously  heated,  and  vice  Vend, — motion  being  the  eijuallv 
instantaneous  effect  in  both  eases.  And.  according  i>>  the  degree  and  duration 
of  the  Electrical  Force  applied,  do  such  bodies  become  simply  electrified— 


LECTURE  IX.  lb5 

preserving  still  their  usual  appearance  and  nature,— or  chemically  decom- 
posed in  some  of  their  constituent  principles — their  atoms  in  either  case  being 
repelled  or  attracted  in  a  novel  manner.  In  a  manner  perfectly  analogous, 
do  every  and  all  of  our  purely  Medicinal  substances  act  on  the  living  orga- 
nism. On  the  dead,  if  they  exercise  any  influence  at  all,  it  can  only  belry 
preventing  the  putrefactive  process,  or  by  chemically  decomposing  the  vari- 
ous parts.  The  old  writers  were  right  when  they  said  "Medicina  non  agit 
in  cadaver."* 

If  you  again  demand  how  a  given  substance  shall  influence  one  part  of  the 
system  rather  than  another,  I  must  again  recur  to  chemistry.  Have  we  not 
elective  affinity,  or  a  disposition  in  inorganic  bodies  to  combine  with,  and  alter 
the  motions  or  modes  of  particular  bodies  rather  than  others  1  By  an  elective 
affinity  precisely  similar,  do  opium  and  strychnia,  when  introduced  into  the  liv- 
ing system,  produce  their  respective  effects ;  they  manifest  a  similar  choice  of 
parts — the  elective  power  of  one  substance  being  shown  by  its  influence  on  the 
nerves  of  sense,  and  that  of  the  other  by  its  effect  on  the  nerves  of  the  mus- 
cular apparatus.  But  here,  again,  you  may,  with  the  most  perfect  propriety, 
ask,  why  the  influence  of  opium  on  the  brain  should  set  one  man  to  sleep, 
and  keep  another  from  sleeping?  and  why  strychnia,  by  a  similar  difference 
of  cerebral  action,  should  paralyse  the  nerves  of  motion  in  one  case,  and  wake 
to  motion  the  nerves  of  the  paralytic  in  another  ?  The  answer  is  simple,  and 
it  affords  a  fresh  illustration  of  the  truth  of  this  electrical  doctrine.  The  atoms 
of  the  specific  portion  of  brain  of  any  two  individuals  thus  oppositely  influ- 
enced in  either  case,  must  be  in  opposite  conditions  of  vital  electricity — nega- 
tive in  one,  and  positive  in  the  other.  And  what  but  opposite  results  could 
possibly  be  the  effect  of  any  agent  acting  electrically  on  any  two  similar 
bodies,  whether  living  or  dead,  when  placed  under  electrical  circumstances 
so  diametrically  opposite  ?  In  common  with  all  medicinal  substances,  opium 
and  strychnia  may  produce  inverse  motions — motion  outward  or  motion  in- 
ward, according  to  the  particular  vito-electrical  condition  of  the  body  to  which 
they  may  be  applied.  And  in  this  instance,  again,  they  only  harmonise  with 
every  thing  we  know  of  the  great  universal  force  to  which  we  ascribe  their 
medicinal  influence.  Their  ultimate  agency  depends  on  attraction  and  repul- 
sion. Here,  then,  Gentlemen,  you  have  the  most  satisfactory  explanation  of 
an  infinity  of  facts  which,  from  their  supposed  confliction,  have,  up  to  this 
hour,  puzzled  every  teacher  and  professor  that  ever  endeavoured  to  grapple 
with  the  subject.  The  merit  of  this  explanation  I  exclusively  claim :  and  I 
state  my  right  to  it  thus  distinctly,  that  no  F.R.S.,  no  Queen's  Physician- 
Extraordinary,  or  other  great  official,  may  hereafter  have  any  excuse  for  at- 
tempting to  snatch  it  from  me — whether  through  ignorance  or  forgetfulness 
of  my  name  and  writings  he  ventured  to  predict  its  future  discovery,  or 
deal  it  out  bit  by  bit  to  his  readers,  in  the  equally  novel  shape  of  question  and 
suggestion  !  Yes,  Gentlemen,  I  exclusively  claim  the  electrical  doc- 
trine of  medicinal  agency  as  mine — a  doctrine  which  affords  an  easy  solu- 
tion of  the  greater  number  of  difficulties  with  which  our  art  has  hitherto  been 
surrounded.  By  following  out  its  principles,  you  see  at  once  why  colchicum, 
mercury,  and  turpentine,  can  all  three  cause  and  cure  rheumatism  ;  why  ace- 
tate of  lead  can  produce  and  relieve  salivation;  whycubebsand  copaiba  have 
relieved  gonorrhoea  in  one  man,  and  aggravated  the  same  disease  in  another; 
why  musk  may  excite  and  stop  palpitation  of  the  heart ;  why  the  fevers  of 
puberty,  pregnancy,  and    small-pox,  have  each  cured   and  caused  every 

*  Arsenic.  Oxymuriate  of  Mercury,  and  Alcohol  inminut*e  dosesfact  electrically  on  the  living 
•tomach,  whether  for  good  or  for  evil.  In  large  doses  all  three  act  chemically  upon  the  same  or 
gan ;  for  they  then  invariably  decompose  it :  but  the  same  doses  applied  to  the  dead  stomach  preserve 
it  from  (the  putrefactive)  decomposition.  The  Mineral  Acids,  when  properly  diluted,  act  Electrically 
upon  the  living  economy.  In  their  concentrated  state  they  decompose  every  part  of  the  body, 
whether  living  or  dead,  to  which  they  may  be  applied.  The  poisons  of  the  Cobra  and  Rattlesnake, 
so  deadly  to  other  animals,  have  no  visible  effect  upon  their  respective  species;  nor,  indeed,  upon 
any  animals  that  want  the  back-bone  ;  they  have  no  influenec  on  shell-fish  or  mollusca.  What  but 
Electricity  in  its  various  modifications  can  explain  all  this  ?     , 


186  LECTURE  IX. 

species  of  disorder  incident  to  the  respective  subjects  of  them:  and  why  the 
passions  have  done  the  same.  Now,  what  better  proof  could  you  have  of  the 
real  nature  of  the  passions  than  this  ?  What  better  evidence  that  rage,  ter- 
ror, joy,  surprise,  are  each  and  all  of  them  indubitable  fevers,  than  that  each 
and  all  of  them  have  cured,  caused,  aggravated,  and  alleviated  almost  every 
human  disease ;  every  ache  and  ailment  to  which  man  is  liable,  from  ague  to 
epilepsy — from  toothache  to  the  gout !  Like  opium  and  quinine,  every  one 
of"  these  passions  has  a  double  electrical  agency  ;  in  one  case,  reversing  the 
particular  cerebral  movements  on  which  existing  symptoms  depend,  in  which, 
case  it  alleviates  or  cures;  in  another,  calling  them  up  or  only  adding 
to  their  rapidity  when  present;  in  which  case,  it  causes  and  aggravates 
simply. 

But  we  have  yet  to  account  for  certain  apparently  anomalous  effects  of  all 
medicines  ;  we  have  still  to  explain  to  you  why  opium,  for  example,  instead 
of  producing  its  usual  somnolent  or  insomnolcnt  influence  upon  particular  in- 
dividuals, acts  upon  them  in  the  same  manner  as  antimony  or  ipecacuan  ; 
and  why  these  particular  medicines,  instead  of  producing  their  usual  emetic 
effect  in  individual  cases,  only  purge  the  patient ;  or  (as  I  have  occasionally 
found  them  do)  set  him  to  sleep  more  surely  than  henbane  or  opium.  Gentle- 
men, did  opium  or  antimony  uniformly  affect  the  identical  portion  of  brain  in 
all  persons,  either  medicine  could  never  do  more  than  one  of  two  things — 
namely,  aggravate  or  ameliorate  the  particular  symptoms  which,  in  all  healthy 
persons,  it  then  most  certainly  could  never  fail  of  producing.  But  in  common 
with  all  medicines,  the  elective  affinity  of  each  of  these  particular  substances 
may  be  different  in  different  persons,  from  difference  of  constitution.  The 
same  medicines,  then,  do  not  always  influence  the  same  cerebral  parts. 
The  usual  elective  affinity  of  opium  and  antimony  may  be  quite  reversed  in 
particular  patients.  Now,  as  all  medicinal  agents  act  solely  by  changing  the 
movements  of  the  cerebral  parts  over  which  they  exercise  their  respective 
influence,  antimony  and  opium,  by  changing  their  usual  places  in  the  system, 
change  their  respective  characters  accordingly.  Antimony,  then,  either  be- 
comes a  narcotic,  or  keeps  the  patient  wakeful.  Opium,  in  like  manner, 
either  becomes  an  emetic,  or  the  reverse  of  an  emetic — whatever  that  be. — 
See,  then,  how  cautious  you  ought  to  be  in  every  new  case  of  disease  for 
which  you  may  be  consulted  :  and  how  necessary  it  is  to  exercise  all  your 
powers  of  circumspection  in  practice.  When  you  prescribe  medicine  of  any 
kind,  vou  ought  to  feel  your  way  with  the  smallest  available  dose — the  smallest 
dose  from  which  you  might,  from  your  experience,  expect  an  appreciable 
effect,  whether  for  good  or  for  evil ;  for,  remember,  not  only  do  all  meiiicines 
occasionally  manifest  a  different  elective  affinity  from  that  which  they  usually 
exercise ;  but,  even  when  they  act  in  their  more  ordinary  course,  they  have 
still  the  double  power  of  attraction  and  repulsion — the  power  of  aggravating 
or  alleviating  the  symptoms  for  which  you  prescribe.  Indeed,  by  this 
duality  of  movement,  and  no  other — attraction  and  repulsion — we  an;  com- 
pelled to  explain  every  variety  of  change  which  the  body  assumes,  whether 
in  health  or  disease.  By  Attraction,  the  fluid  matter  of  a  secretion  becomes 
consistent  and  organised,  again  to  be  thrown  off"  by  the  same  organ,  in  the 
fluid  form  of  secretion,  by  Repulsion. 

Throughout  all  creation,  we  find  unity  the  effect  of  diversity  or  repetition. 
There  can  be  no  symmetry  without  this;  the  most  rugged  line  you  can  ponr- 
tray,  when  opposed  to  its  perfect  repetition,  immediately  becomes  n  auigm 
— a  unity.  Man  in  the  abstract,  is  a  unity  of  tin'  two  sexes.  The  unity  of 
the  individual  man  is  made  up,  as  we  have  already  seen,  of  a  duplex  repeti- 
tion that  pervades  his  entire  configuration  outwardly  as  well  as  inwardly. — 
The  life  of  man  in  all  its  functions  is  a  thing  of  periodic  repetitions.  "His 
passions,  in  like  manner,  are  duplex.  Joy,  woe.  confidence,  t'enr,  low,  hate, 
are  examples.  Originally  the  gifts  of  a  "benevolent  Providence  for  bis  use, 
bis  preservation,  and  the  preservation  of  his  race  :  when  abused,  they  be- 


LECTURE  IX.  187 

come  the  elements  of  destruction  to  both.  To  keep  them  in  healthy  subjec- 
tion is  wisdom  ;  to  attempt  their  utter  annihilation,  not  only  involves  their 
possessor  in  a  perpetual  struggle  against  the  laws  of  his  nature,  but  actually 
aims  at  defeating  the  ends  of  creation.  All  things,  then,  have  two  aspects. 
The  unity  of  action  of  medicine  and  poison,  is  proved  by  the  duality  of  mo- 
tion and  temperature,  which  the  substances  so  denominated  are  capable  of 
producing. 

In  its  duality  of  heat  and  cold,  what  disease  has  not  temperature  pro- 
duced ?  What,  in  the  shape  of  the  warm  and  cold  baths,  has  it  not  cured  ? 
Look,  again,  at  the  effect  of  heat  upon  the  egg.  Even  when  artificially  ap- 
plied, we  see  this  apparently  inert  body  converted,  by  thermal  influence,  into 
bone,  skin,  and'  muscle,  with  their  proper  apparatus  of  blood-vessels  and 
nerves  ?  You  will  tell  me,  the  egg  was  predisposed  to  such  changes.  True  ; 
and  temperature  can  only  act  upon  all  things,  according  to  their  original  pre- 
disposition. Is  not  this  the  reason  why  a  chill  will  produce  rheumatism  in 
one  man,  and  consumption  in  another  1  Through  thermal  influence,  the 
wool  of  the  sheep  and  the  feathers  of  the  hen,  may  in  successive  generations 
be  replaced  with  hair ;  certain  viviparous  animals  may  even  be  made  ovipar- 
ous in  this  manner.  The  aphis  and  the  wood-louse,  for  example,  may  be 
made  to  bring  forth  either  eggs  or  live  young,  at  the  pleasure  of  the  experi- 
menter, by  simply  varying  the  temperature  in  which  he  keeps  them.  Then, 
again,  look  at  the  effects  of  temperature  upon  the  vegetable  world  !  If  in  the 
middle  of  winter,  you  introduce  the  branch  of  a  vine,  which  happens  to  grow 
by  your  window,  into  your  warm  chamber,  and  keep  it  there  for  a  few 
weeks,  it  will  put  forth  leaves  and  blossom.  See,  then,  the  wide  and  omni- 
potent influence  of  temperature  on  every  living  thing,  from  man,  who  only 
attains  the  maturity  of  his  growth  in  the  course  of  successive  summers,  to  the 
gourd,  that  springs  up  and  perishes  in  a  night. 

Having  premised  this  much,  we  shall  now,  Gentlemen,  enter  upon  a  con- 
sideration of  particular  medicines.  And,  first,  let  us  speak  of  such  as  have 
a  general  constitutional  influence,  with  an  affinity,  more  or  less  marked,  for 
particular  organs.     Of  these,  the  most  important  are 

Emetics.— When  the  various  doctrines,  which  attributed  all  diseases  to  acri- 
monies, peccant  humours,  crudities,  &c,  prevailed  in  the  schools,  Emetics  were 
among  the  principal  remedies  to  which  physicians  very  naturally  resorted,  as  a 
preliminary  means  of  cure.  The  beneficial  effect  observed  to  take  place  after 
vomiting,  in  the  early  stage  of  almost  all  disorders,  was,  of  course,  urged  in  con- 
firmation of  theories  which,  even  in  the  present  day,  are  not  without  their  in- 
fluence on  the  minds  of  medical  men.  The  primary  action  of  Emetics  we  hold 
to  be  Cerebral,  and  the  act  of  vomiting,  not  so  much  a  cause  of  the  other 
constitutional  symptoms  which  accompany  it,  as  one  of  many  effects  produc- 
ed by  change  in  the  atomic  revolutions  of  the  Brain.  Whatever  will  sud- 
denly influence  the  Brain,  in  any  unusual  or  novel  manner,  by  changing  its 
temperature  and  atomic  motion,  must  necessarily  change  the  whole  corporeal 
state,  whether  it  be,  at  the  time,  in  health  or  disease.  Have  we  not  this 
familiarly  exemplified,  in  the  motion  which  causes  sea-sickness ;  in  the  sick- 
ness produced  by  the  rotatory  chair,  and  in  the  morning  vomitings  of  early 
pregnancy  ?  Anything  that  can  withdraw  the  Brain's  attention  from  the 
stomach,  such  as  a  passion,  a  blow  on  the  head,  loss  of  blood,  or  a  division 
of  the  nerves  that  supply  it,  may  produce  vomiting.  Experience  every 
day  shows  us,  that  the  shivering  or  shudder  liable  to  be  occasioned  by 
one  cause,  may  be  averted  or  cut  short  by  agents  which,  under  different  cir- 
cumstances, can  of  themselves  produce  such  muscular  tremor.  It  is  thus 
that  the  Emetic  exerts  its  salutary  influence  in  disease.  No  man  can  take  a 
vomit,  without  every  part  of  the  body  undergoing  some  change  during  its  op- 
eration. A  creeping  sensation  is  immediately  felt  in  every  part — a  sensa- 
tion demonstrative  of  the  rapid  revolution  and  change  of  relation  of  every 
corporeal  atom.     Under  the  influence  of  such  an  agency,  you  may  see  the 


188  LECTURE  IX. 

reddened  and  swollen  eye,  or  testis,  become,  in  a  few  minutes,  of  nearly  its 
natural  appearance  ;  nay,  a  complete  abatement  of  pain  in  either  organ, 
may  be  an  equally  rapid  result.  Who,  then,  will  tell  me,  that  the  same 
effect  may  not  take  place  from  the  employment  of  an  Emetic  in  what  arc 
termed  inflammations  of  the  lungs  or  bowels  ?  Oh,  "  all  experience  is  against 
it!"  I  have  been  told.  All  experience  !  Whose  experience  ?  I  have  asked ; 
but  I   never  got  an   answer,  for  nobody   had  ever  tried. 

But,  for  a  period  now  of  Seven  years,  Staff-Surgeon  Hume,  in  his  Mili- 
tary Hospital,  has  treated  his  pleuritic  and  enteritic  patients  in  this  manner : 
during  all  that  time  he  has  not  bled  or  leeched  one  patient  for  any  disease — 
he  has  used  Emetics  instead — and  his  practice  has  been  beyond  all  precedent 
successful.  Now,  that  I  call  a  Fact — a  fact  worth  all  the  hypothetical  as- 
sumptions of  people  whose  gains  depend,  not  so  much  on  speedy  cure,  as  on 
protracted  sickness  !  There  is  no  part  of  the  body  that  you  may  not  influ- 
ence by  an  Emetic ;  the  6ld  physicians  knew  this ;  the  physicians  of  an  age 
gone  by.  They  gave  Emetics  in  the  case  of  Typhus  even — Typhus  in  a 
Royal  patient.  "Louis  XIV.,"  says  Mr.  James,  in  his  Life  of  that  mon- 
arch, was  seized  with  symptoms  of  illness,  and  all  the  marks  of  Typhus 
Fever,  of  the  most  malignant  kind,  soon  discovered  themselves.  The  whole 
court  was  in  consternation,  the  queen  in  despair  .  .  .  Mazarin  was  too  much 
agitated  and  terrified  to  use  any  concealment;  with  fears  and  sighs,  he  ac- 
knowledged to  Louis  at  once  the  danger  in  which  he  was;  and  the  young 
monarch  only  seemed  grateful  to  him  for  not  having  concealed  his  situation. 
A  physician  of  great  repute,  however,  was  at  length  brought  from  Abbeville ; 
and  declaring  that  the  king's  case  was  by  no  means  hopeless,  he  obtained 
permission  to  administer  to  him  a  remedy,  which  there  is  every  reason  to 
believe  was  merely  antimonial  wine.  Louis  was  so  much  relieved  by  the 
first  Emetic,  that  he  willingly  took  a  second  dose,  and  from  that  day  the 
fever  abated,  and  health  gradually  returned.  Joy  and  satisfaction  spread 
throughout  France." 

Of  the  value  of  Emetics  in  Apoplexy,  I  could  give  numerous  cases  of  my 
own  in  illustration.  I  prefer  the  evidence  of  others.  Take  the  case  of 
another  Royal  Patient.  Frederick  the  Great,  »  three  days  before  the  grand 
autumn  manoeuvres,  complained  of  pains  in  his  legs  :  on  retiring  to  bed  at 
eight  in  the  evening,  he  made  the  same  complaint,  though  he  had  been  in 
high  spirits  the  whole  day,  especially  at  table.  At  ten  he  had  a  violent  at- 
tack of  apoplexy,  which  must  have  proved  fatal,  but  for  the  prompt  applica- 
tion of  heat  and  i he  administration  of  Emetics  and  hot  tea." — [Campbell's 
Life  of  Frederick.] 

A  medical  officer,  of  the  East  India  Company's  service,  sent  forme  at  mid- 
night, and  you  may  imagine  the  pain  he  was  suffering,  when  I  tell  you  that 
I  heard  his  groans  before  I  reached  his  chamber.  Shortly  after  leaving  a 
crowded  theatre,  he  had  imprudently  taken  his  place  on  the  top  of  one  of 
the  night  coaches,  when1  he  had  not  been  long  seated  before  he  was  seized 
with  repeated  shivering,  followed  by  fever  and  exquisite  pain  in  the  back  and 
loins — in  medical  phrase,  lumbago.  When  I  saw  him,  he  had  all  the  symp- 
toms which,  in  the  Schools,  are  termed  high,  inflammatory  fever,  and  he 
complained  of  agonising  pain  in  his  back.  His  wish  was  to  be  bled,  but  I 
prescribed  an  Emetic  instead,  and  this  relieved  him  in  the  briefest  space  im- 
aginable. From  the  moment  he  vomited,  his  back  became  easier,  and  in  a 
few  minutes  he  was  quite  free  from  pain — a  result  equally  pleasing  and  aston- 
ishing to  the   patient,  who,  on    a  previous  occasion,  had   been  confin 

BO  bed  with  a  similar  attack,  notwithstanding  repeated  bleedings,  leech- 
ings,  and  blisters.  Another  gentleman,  who  shortly  alter  came  under  my 
care,  experienced  a  like  relief  from  the  use  of  an  Emetic  in  nearly  the  same 
circumstances.  In  the  first  rasp,  1  followed  up  the  Kim  tic  with  hydrocyanic 
acid  ;  in  the  second,  I  prescribed  quinine  and  sulphuric  acid—the  latter,  my 
not         neral   mode  of  treatment  in  acute  disease.     Cases   without   number 


LECTURE"  IX.  189 

could  I  give  of  the  beneficial  influence  of  this  practice  in  acute  ophthalmia, 
sore-throat,  pleurisy,  rheumatism,  &c,  diseases  which,  under  the  usual  or 
orthodox  measures,  would  have  kept  the  physician  in  attendance  for  weeks, 
and  then,  perhaps,  have  defied  both  his  aid  and  his  art.  With  the  same 
practice,  I  have  had  equal  success  in  the  treatment  of  hasmorrhages,  eruptive 
fevers,  <fcc. ;  and  I  might  here  give  cases  corroborative  of  my  assertion,  were 
I  not  borne  out  by  many  of  the  older  writers,  particularly  Heberden  and 
Parr,  who  found  Emetics,  followed  by  Bark,  to  be  the  best  primary  treat- 
ment of  disorder  generally.  John  Hunter  says,  he  has  seen  "  Buboes  (col- 
lections of  matter  in  the  groin)  cured  by  a  vomit,  after  suppuration  had  been 
considerably  advanced,"  and  he  has  "known  a  large  bubo,  which  was  just 
ready  to  break,  absorbed  from  a  few  days'  sickness  at  sea."  He  attests  the 
cure  of  "  White-swelling,"  or  knee-consumption,  by  emetics,  and  the  value  of 
the  same  class  of  medicines  in  pulmonary  consumption  has  been  strongly  in- 
sisted upon  by  many  writers.  In  physic,  as  in  everything  else,  there  is  a 
fashion;  but  the  "great  men"  of  our  day,  notwithstanding  their  reiterated 
assertions  to  the  contrary,  would  do  well,  in  more  instances  than  these,  to  im- 
itate the  old  practice. 

The  principal  substances  used  as  Emetics  are  Antimony,  Ipecacuan,  Zinc, 
and  Copper  ;  but  a  great  many  others  might  be  added  :  Tobacco,  Squill,  and 
Coichicum  in  large  doses, — to  say  nothing  of  luke-warm  water,  which  last, 
from  its  relation  to  Temperature,  will  readily  occur  to  you  as  the  best  exponent 
of  the  mode  of  action  of  all.  With  some  people  Opium  will  vomit,  where 
Ipecacuan  would  fail.  There  are  individuals  whom  no  known  agent  can 
vomit,  and  others,  in  whom  the  common  Emetics  act  always  as  Purgatives. 
This  you  cannot,  of  course,  know  before-hand  ;  so  that  the  experience  of 
every  individual  case  is  the  only  rule  by  which  such  case  is  to  be  treated. 
We  must  now  speak  of 

Purgatives,  or  those  medicines  which  influence  the  intestinal  secretions. 
Like  most  remedies,  these  all  act  through  the  medium  of  the  Brain — but,  from 
ignorance  of  their  mode  of  action,  practitioners  have  too  frequently  converted 
them  into  a  cause  of  disease  and  death.  The  man  who  proceeds  day  by  day 
to  purge  away  "  morbid  secretions,"  "  peccant  humours,"  &c,  is  a  mere 
humoralist,  who  neither  knows  the  manner  in  which  his  medicines  operate, 
nor  understands  the  nature  of  the  wonderful  machine  whose  disordered  springs 
he  pretends  to  rectify.  Do  not  let  me  be  understood  to  depreciate  the  use 
of  purgative  medicines.  As  remedial  means  they  are  inferior  to  emetics; 
when  combined  with  these,  they  are  among  the  best  medicines  with  which 
to  commence  the  treatment  of  disease  generally  ;  that  is,  where  the  patient 
has  not  been  previously  reduced  by  protracted  suffering.  It  has  been  my 
fate  to  witness  no  inconsiderable  amount  of  mischief  induced  by  a  mistaken 
perseverance  in  purgative  measures.  Will  nothing  open  the  eyes  of  gentle- 
men of  the  humoral  "school  ?  Surely  they  will  be  staggered  when  told,  that 
in  an  evil  hour  the  exhibition  of  a  purge  has  been  followed  by  a  paroxysm  of 
gout  ?  Yet  nothing  is  more  true  or  better  avouched.  "  Reasoning  upon 
this  simple  fact,"  Dr.  Parr  says,  '•  the  humoral  theory  of  gout  is  altogether 
untenable."  And  so  is  Dr.  Holland's  hypothesis  of  its  being  caused  by  a 
"  morbid  ingredient  in  the  blood."  When  I  say  I  have  known  fatal  fevers 
produced  by  medicines  of  this  class,  some  may  be  sceptical ;  but  few  will 
doubt  their  power  to  produce  dysentery,  which,  in  the  words  of  Cullen,  is  an 
"inward  fever."  "A  dose  of  rhubarb,"  says  Dr.  Thompson,  "has  pro- 
duced every  symptom  of  epilepsy,  and,  in  an  instance  within  my  own  obser- 
vation, the  smallest  dose  of  calomel  has  caused  the  most  alarming  syncope." 
Let  us  use,  not  abuse,  purgative  medicines  ! 

Mercury. — The  frequency  with  which  mercury  and  its  preparation  calo- 
mel, enter  into  medicinal  prescriptions ;  its  beneficial  and  baneful  influence 
in  the  practice  of  our  art,  render  a  knowledge  of  the  true  action  of  this 
metal,  and  the  proper  mode  of  its  exhibition,  matters  of  no  ordinary  im- 
portance. 


190  LECTURE  IX. 

What  are  the  forms  of  disorder  in  which  mercury  is  supposed  to  be  moat 
useful  ?  The  records  of  the  profession  answer,  fevers,  iritis,  erysipelas, 
dysentery,  rheumatism,  cutaneous,  osseous,  and  glandular  disturbances.  To 
the  same"  records,  I  appeal  for  testimony  to  the  truth  of  my  statement,  that 
it  has  too  frequently  produced  those  very  maladies  in  all  and  every  of  their 
forms  and  variations.  Its  influence  extends  principally  over  the  glandular 
and  assimilative  systems  ;  it  has  consequently  a  great  effect  on  secretion.  I 
have  known  mercury  in  small  doses  cure  what  is  termed  scrofula  hundreds 
of  times  ;  yet,  according  to  Sir  Charles  Bell — and  I  can  bear  him  out  in  the 
fact — when  wrongly  applied,  mercury  has  set  up  "  a  scrofula  diathesis  in  the 
very  best  constitutions."  " I  have  seen  a  person,"  says  Dr.  Graves,  "labour- 
ing under  mercurial  irritation,  seized  with  common  fever,  which  afterwards 
became  typhus,  and  proved  fatal  in  five  days.  Still  you  will  hear  persons  say, 
that  if  you  get  a  fever-patient  under  the  influence  of  mercury,  you  will  cure 
the  disease,  and  that  mercurial  irritation  will  protect  a  man  against  fa\er.  1 
have  known  jaundice  to  appear  during  a  course  of  mercury" — -jaundice,  for 
which  some  say  it  is  a  specific  !  When  you  hear  a  man  talking  of  "  speci- 
fics," you  may  well  laugh  at  him  !  The  value  of  all  medicines  has  more  or 
less  relation  to  the  quantity  prescribed.  Upon  this  subject,  I  think  it  material 
to  speak  regarding  mercury  ;  for  in  consequence  of  the  enormous  doses  which 
have  been  exhibited  by  certain  pseudo-physicians — certain  writers  on  infan- 
tile and  tropical  disease — this  substance,  instead  of  being  a  blessing  to  hu- 
manity, has  recently  become  one  of  the  chief  agents  in  man's  destruction ! 
You  daily  see  medical  men — men  who  never  reflect  upon  the  effect  of  any 
medicine — prescribing  four,  five,  and  six  grains  of  calomel  to  children — to  in- 
fants !  Can  you  wonder  at  the  frightful  number  of  deaths  that  take  place 
under  seven  years  of  age  ?  Look  at  the  bills  of  infantile  mortality  ;  and  if 
you  consider  the  quantity  of  calomel  that  children  take,  you  will  assuredly 
be  compelled  to  declare,  not  how  little  medicine  has  done  for  the  prolongation 
of  life,  but  how  much  it  has  done  to  shorten  it !  Oh  !  you  may  depend  upon 
it,  there  is  a  great  deal  of  mischief  done  by  the  profession ;  that  is  the  reason 
why  people  go  to  the  quacks  and  homceopathists.  The  latter  are  the  least 
mischievous,  for,  if  they  actually  give  their  medicines  in  the  ridiculous  doses 
they  pretend,  they  do  little  more  than  hocus  their  patients  with  words,  while 
the"  quacks  and  the  medical  men  kill  them  wholesale  by  physic — physic 
wrongly  applied.  Many  years  have  now  passed  since  Mr.  Abernethy  first 
advocated  the- employment  of  mercury  in  moderate  doses.  More  recent  writers 
have  demonstrated  the  value  of  calomel  in  doses  so  minute  as  the  twelfth 
and  even  sixteenth  part  of  a  grain.  Combined  with  equally  minute  quan- 
tities of  quinine,  I  have  been  for  years  in  the  habit  of  prescribing  it  in  such 
doses,  in  all  diseases  of  children,  and  I  have  found  it  invaluable  in  most.  If, 
with  such  minute  doses  of  mercury,  then,  the  practitioner  may  obtain  the 
most  excellent  effects,  what  shall  we  say  to  the  exhibition  of  four  and  five 
grain  doses  of  calomel  to  infants  ?  What  language  can  be  sufficiently  strong 
to  denounce  the  equally  daring  practice  of  ordering  scruple-doses  of  the  same 
powerful  mercurial  for  adults  ?  That  individuals  occasionally  recover  from 
serious  disease,  after  the  unsparing  use  of  calomel  in  such  doses,  is  no  more 
an  argument  in  favour  of  such  a  mode  of  treatment,  than  that  many  a  man 
has  been  knocked  down  by  a  blow,  and  lived  to  laugh  at  a  description  of  ac- 
cident to  which  others  have  succumbed.  To  reason  in  this  manner  is  to 
argue  that  blows  are  good  things.  In  saying  this  much,  I  do  not  mean  to 
raise  objections  to  calomel  as  a  purgative,  in  which  case  a  larger  dose  is 
necessary.  But  how  often  do  you  see  this  mercurial  given  in  enormous 
and  repeated  doses,  with  the  view  of  correcting  morbid  secretions,  which  in- 
quiry might  have  satisfactorily  traced  to  the  previous  mal-administrntion 
of  calomel  itself!  Calomel,  like  every  other  remedial  means,  is  a  medicine 
or  a  poison,  according  to  the  quantity  of  the  agent,  ami  its  fitness  or  unfitness 
for  the  constitution  of  the  patient.     This  last,  as  we  have  previously  hinted) 


LECTURE  IX.  191 

depends  upon  the  electrical  state  of  the  individual  body,  and  can  only  be  known 
by  trial.  You  cannot  tell  that  a  given  piece  of  steel  is  magnetic  or  not  till  you 
try ;  no  more  can  you  tell  the  electrical  state  of  the  living  body.  It  is  only  by  ex- 
perience you  can  know  it.  Calomel,  then,  has  no  exclusive  relation  to  nomen- 
clature ;  yet  you  will  hear  practitioners  say,  "  It  is  not  proper  for  this  disease, 
but  it  is  proper  for  that ;"  "it  is  good  for  jaundice,  but  bad  for  consumption." 
All  this  is  mere  scholastic  folly,  based  upon  "  the  baseless  fabric"  of  a  hypo- 
thesis !  There  is  no  disease,  however  named,  where  the  administration  of 
mercury,  in  some  of  its  preparations,  may  not  be  advantageously  employed 
or  the  reverse,  according  to  particular  doses  and  constitutions.  How  is  it 
that  the  oxymuriate  of  mercury,  formerly  so  much  extolled  by  the  physicians, 
is  now  so  seldom  prescribed  ?  A  more  effective  remedy  for  numerous  forms 
of  disease  is  scarcely  to  be  found  in  the  Materia  Medica.  I  have  more  par- 
ticularly experienced  its  valuable  aid  in  the  treatment  of  dropsy,  dyspep- 
sia, paralysis,  and  eruptions.  Very  analogous  to  mercury  in  its  mode  of 
action  is 

Iodine — Its  influence  on  glandular  parts,  and  consequently  upon  secretion, 
is  very  remarkable.  But,  Gentlemen,  like  every  other  remedial  agent, 
iodine  cuts  two  ways — atomically  attracting  or  lessening  volume  and  secre- 
tion in  one  case,  atomically  repelling  or  increasing  both  in  another,  according 
to  the  electric  state  of  the  individual  body  for  which  it  may  be  prescribed. — 
Now,  the  fact  that  iodine  can  cause  as  well  as  cure  glandular  diseases,  is  not 
known  to  the  profession  ;  at  least  I  have  not  seen  it  noticed  in  the  course  of 
my  reading.  It  behoves  me,  therefore,  to  state,  that  I  have  been  frequently 
obliged  to  countermand  its  exhibition  in  the  treatment  of  bronchocele  and 
other  enlarged  glands,  from  the  obvious  increase  of  these  tumours  undei  its 
use.  In  such  cases,  patients  have  told  me  they  were  not  so  well  in  them- 
selves, that  they  had  had  shivering  fits,  or  had  suffered  from  inward  fever; 
for,  like  mercury,  iodine  has  also  a  general  febrile  effect  upon  the  system,  for 
good  in  one  case,  for  evil  in  another.  As  regards  my  own  practice,  I  have 
found  quinine  more  generally  successful  in  the  treatment  of  glandular  affec- 
tions than  iodine.  In  a  case  of  goitre,  that  resisted  both,  a  very  great  dimi- 
nution of  the  swelling  took  place  after  a  short  trial  of  arsenic.  But  here  I 
may  observe,  that  a  remedy  which  may  be  found  to  be  generally  well  adapted 
to  the  treatment  of  a  particular  type  of  disorder  in  one  locality,  may  be  found 
to  be  as  generally  prejudicial,  when  applied  to  the  same  type  in  another. 
This,  to  a  certain  extent,  may  account  for  the  encomiums  which  individual 
medicines  receive  from  the  profession  one  day,  and  the  contempt  with  which 
they  are  very  often  treated  the  next.  With  iodine  I  have  cured  osseous  and 
cutaneous  complaints  ;  and  I  have  also  found  it  useful  in  the  treatment  of 
consumption  and  dropsy. 

Lead. — The  acetate  of  Lead  is  a  valuable  agent  in  good  hands,  and  was 
long  celebrated  as  a  remedy  for  Consumption.  I  have  cured  eruptions  by  it, 
eruptions  that  resisted  everything  else  I  could  think  of.  "  One  effect  of  the 
continued  use  of  acetate  of  lead,"  says  Dr.  A.  T.  Thompson,  "is  the  excite- 
ment of  ptyalism  (salivation,)  but  notwithstanding  this  effect,  it  has  been  re- 
commended by  Mr.  Daniels  for  the  purpose  of  allaying  violent  salivation,  in 
doses  of  ten  grains  to  a  scruple,  in  conjunction  with  ten  grains  of  compound 
powder  of  ipecacuan.  How,"  asks  Dr.  Thompson,  "  are  these  contending 
opinions  to  be  reconciled  ?"  How,  but  by  the  rule  that  the  power  which 
can  move  one  way,  may  move  the  other,  according  to  the  Electrical  condi- 
tion of  the  individual  Brain  1  This  question,  coming  from  a  professor  of  ma- 
teria medica,  shows  you  that  professors  have  yet  to  learn  the  Duplexity  of 
action  of  all  medicinal  substances. 

Tar — Creosote. — From  innumerable  trials  of  Tar,  and  its  preparation 
Creosote,  I  am  enabled  to  speak  satisfactorily  of  the  remedial  power  of  both. 
In  small  doses.  Creosote  produces  a  mild  Fever,  often  beneficial  in  dyspep- 
tic   and  hysteric  cases,  though  in  some  instances,  like  every  other  agent  in 


192  LECTURE  IX. 

nature,  it  occasionally  disagrees.  I  have  been  obliged  sometimes  to  discon- 
tinue its  use  from  the  vomiting  of  which  the  patient  complained  after  taking  it ; 
though,  where  vomiting  was  a  previous  symptom,  I  have  succeeded  in  stop- 
ping it  by  Creosote.  Generally  speaking,  I  have  found  Creosote  an 
excellent  remedy  in  dropsy,  rheumatism,  and  cutaneous  disorders. 
I  once  cured  with  it  a  case  of  amaurotic  blindness  of  both  eves, 
where  the  disease  was  of  considerable  standing.  The  remedy  "was 
pushed  as  high  as  twenty  drops  for  a  dose  ;  I  commenced  with  two  drops. 
The  efficacy  of  tar-water  in  the  treatment  of  all  kinds  of  disease,  was  the 
universal  belief  of  the  latter  half  of  the  last  century.  The  celebrated  Bish- 
op  Berkeley  wrote  a  treatise,  which  contributed  greatly  to  bring  it  inl 
ion.  "  From  my  representing  tar-water,"  he  says,  "  as  good  for  so  many 
things,  some  perhaps  may  conclude  it  is  good  for  nothing ;  but  charity 
obligeth  me  to  say  what  I  know  and  what  I  think,  howsoever  it 
may  be  taken.  Men  may  censure  and  object  as  they  please,  but  I 
appeal  to  time  and  experiment :  effects  misimputed  ;  case  wrong  told,  cir- 
cumstances overlooked,  perhaps,  too,  prejudices  and  partialities  against 
Truth — may,  fur  a  time,  prevail  and  keep  her  at  the  bottom  of  her  well,  from 
whence,  nevertheless,  she  emerges  sooner  or  later,  and  strikes  the  eves  of  all 
who  do  not  keep  them  shut."  The  Bishop  sums  up  the  catalogue  of  its  vir- 
tues, by  saying,  "  It  is  of  admirable  use  in  fevers." 

Sulphur, — though  now  seldom  used,  except  for  diseases  of  the  skin, 
was  long  extensively  employed  in  physic.  With  the  vulgar,  it  is  still  a  rem- 
edy for  ague.  Like  creosote,  it  produces  a  mild  febrile  effect,  which  mav  be 
turned  to  account  in  numerous  disorders,  especially  in  dyspepsia,  hysteria  ; 
also  in  rheumatism,  which  last  I  have  often  cured  with  it,  after  every  other 
remedy  usually  employed  for  that  distemper  had  successively  failed'  The 
most  generally  influential  agent  in  rheumatism  is 

Colchicum  or  Meadow  Saffron,  the  medicinal  principle  of  which  is  an 
alkali,  termed  Veratria,  or  Veratrine  ;  and  an  admirable  medicine  it  is, 
when  carefully  and  cautiously  administered.  Now  Colchicum,  like  sul- 
phur, has  cured  the  ague  :  and  its  efficacy  in  this  case  depends  upon  the 
mild  Febrile  action,  which,  like  Hope,  or  Joy,  it  has  the  power  of  produc- 
ing. If  it  has  relieved  pain  and  swelling  in  many  cases,  so  also  can  it  pro- 
duce both;  a  reason  why  you  should  watch  its  effects  ;  for  where  it  fails  to  im- 
prove, it  commonly  aggravates.  Like  all  other  medicinal  agents,  it  is  a 
motive  power,  and  if  it  fail  to  move  matter  the  right  way,  it  must  occasional- 
ly move  it  the  wrong.  The  mildest  remedial  substance,  when  taken  by  a 
person  in  perfect  health,  if  it  act  at  all,  must  act  prejudicially.  What  is  "the 
action  of  Colchicum,  in  such  cases  ?  According  to  the  journals  of  the  day, 
pains  of  the  joints  and  feet  were  among  the  symptoms  produced  by  it.  when 
accidentally  taken  in  poisonous  quantities  by  previously  healthy  persons  :  the 
very  pains  for  which  we  find  it  available  in  practice  ! 

Squills,  Digitalis — Are  physicians  aware  that  both  of  these  substances 
have  the  power  of  suspending  as  well  as  of  increasing  the  secretion  from  the 
kidneys?  They  are  often  continued  too  long  in  dropsy,  to  the  prejudice  of  the 
patient,  from  practitioners  being  ignorant  of  their  double  action.  But  in  this 
respect  they  only  harmonise  with  all  known  agents.  The  Electrical  state  of 
the  body,  which  cannot  be  known  but  by  an  experience  of  their  effects  upon 
it,  determines  whether  Squill  or  Digitalis  prove  aggravant  or  remedial. 

Stramonium  or  Thornaitle  is  used  by  the  Asiatics,  in  their  treatment 
of  mania — a  disease  which  it  has  produced.  It  can  also  produce  erup- 
tions of  the  skin,  a  fact  which  led  me  to  try  its  effects  in  cutaneous  dis- 
ease. Combined  with  belladonna,  I  have  cured  some  very  obstinate  erup- 
tions with  Stramonium.  I  have  also  employed  ihe  same  combination  ad- 
vantageously in  the  treatment  of  pulmonary  consumption.  The  general  ac- 
tion of  both' remedies  in  small  doses,  is  mildly  febrile.  Their  use  sometime! 
produces  a  temporary  dimness  of  sight,  which  goes  oil  when  the  remedies 
aro  Stopped. 


LECTURE  IX.  193 

Tobacco,  Lobelia  Inflata. — Tobacco  is  a  valuable  remedy,  when 
properly  prescribed,  and  it  may  be  administered  internally  as  well  as  exter- 
nally. I  have  found  its  internal  use,  in  tincture,  efficacious  in  dropsy  and 
asthma.  Heberden  cured  a  case  of  epilepsy,  by  applying  a  cataplasm 
of  Tobacco  to  the  pit  of  the  stomach.  The  lobelia  injlala,  or  American 
Tobacco,  is  a  good  diuretic,  and  has  cured  asthma.  Like  the  common  to- 
bacco, it  produces  sickness,  in  large  doses. 

The  Balsams  and  Gums. — Copaiba,  Turpentine  and  Guaiac  powerfully 
influence  mucous  surfaces,  in  one  case  increasing  secretion,  in  another  suspend- 
ing it.  Turpentine  is  also  a  Chrono-Thermal  remedy.  With  it,  I  have 
cured  cases  of  Iritis,  which  resisted  mercury  and  quinine.  Copaiba  in  some 
constitutions  produces  a  cuticular  eruption  so  like  small-pox,  that  even  medi- 
cal men  have  supposed  it  to  be  that  disease.  Others,  putting  this  rash  down 
to  a  fanciful  cause  called  Syphilis,  have  gravely  proceeded  to  ruin  their  pa- 
tients' constitutions  with  mercury,  to  cure  what  they  were  pleased  to  call 
"  secondary  symptoms  !"  All  these  medicines  are  useful  in  Rheumatism, 
which  they  can  produce. 

Cantharides  or  Spanish  Fly. — This  is  principally  used  as  a  blister  ; 
but  the  tincture  of  Spanish  Fly  is  an  admirable  internal  remedy  for  gleet 
and  leucorrhcea,  and  it  is  also  among  our  best  diuretics  ;  remember,  however, 
it  can  produce  stranguary,  an  opposite  effect.  I  am  in  the  habit  of  combining 
it  with  quinine  and  prussic  acid,  in  the  treatment  of  dyspeptic  cases,  and  I 
find  it  useful  also  in  cuticular  disease  ;  though  in  the  case  of  one  gentleman — 
a  colonel  of  the  army — a  blister  to  the  side  had  the  effect  of  blistering 
him  all  over  on  both  of  two  occasions  in  which  it  was  tried. 

The  Earths  and  Alkalis  have  all  particular  effects  upon  the  body,  ac- 
cording to  the  mode  and  degree  in  which  they  are  administered.  Besides 
their  constitutional  influence,  each  has  more  or  less  affinity  to  special  organs. 
Lime  and  Bary  tesinfluence  the  secretions  of  the  stomach  ;  Soda  and  Potash 
those  of  the  lungs,  kidney,  and  bladder  ;  Ammonia  or  Hartshorn  affects  the 
salivary  glands — each  for  good  or  for  evil,  according  to  its  dose  and  fitness  for 
particular  constitutions.  The  earth  called  Alum  is  a  favourite  with  the  com- 
mon people,  in  the  cure  of  ague.  What  is  its  mode  of  action  ?  Its  power  of 
astringency  or  attraction  simply — the  same  power  by  which  it  arrests  the 
morbid  increase  of  secretion,  called  leucorrhoea.  How  does  it  do  that  ?  By 
its  attractive  influence  over  the  atoms  of  the  spine  and  the  nerves  proceeding 
from  the  spine.  Well,  then,  that  i9  the  way  in  which  it  cures  the  ague. 
The  greater  number  of 

The  Acids  have  been  usefully  employed  in  medicine.  Acetic  acid,  or 
vinegar,  is  an  old  remedy  for  hiccup,  and  might  be  efficacious  in  other  spas- 
modic diseases.  Dilute  sulphuric  acid  has  cured  the  ague,  among  other  dis- 
orders. With  dilute  nitric  acid,  I  have  arrested  and  increased  almost  every 
secretion  of  the  body,  according  to  varying  circumstances.  For  a  gentleman 
who  was  affected  with  vertigo  and  tremor,  I  prescribed  dilute  nitric  acid, 
which  cured  him  ;  his  wife,  by  mistake,  took  his  medicine  for  her  own,  and 
in  a  few  minutes  afterwards,  she  was  affected  with  a  tremor,  that  lasted  for 
nearly  an  hour !  You  see,  as  a  general  rule,  then,  that  whatever  can  move 
one  way,  can  move  the  other. 

Gentlemen,  the  medicines  of  which  I  have  given  you  some  account  to-day, 
are  the  principal  symptomatic  medicines  which  I  employ  in  my  own  practice, 
combining  or  alternating  them,  as  I  have  already  stated,  with  the  chrono- 
thermal  remedies.  But  there  are  thousands  of  other  agents,  which  may  be 
usefully  employed  in  this  manner,  and  a  great  number  are  mentioned  in  our 
books  of  Materia  Medica.  What  I  have  said  on  the  action  of  remedies 
generally,  will  apply  to  all.  At  our  next  lecture,  I  shall  give  you  some  ac- 
count of  the  principal  chrono-thermal  agents;  and  conclude  the  course  by  a 
general  summary  of  the  Chrono-Thermal  Doctrine. 


194  LECTURE  X. 


LECTURE  X. 

principal   chrono-thermal  remedies  —  summary  of  the   chroko- 
tiiermal  doctrine  of  disease. 

Gentlemen, 

We  now  come  to  consider  the  mode  of  action  of  the  chrono-thermal 
agents,  or  those  substances  so  generally  effectual  in  prolonging  that  remission 
of  symptom  which  we  have  proved,  beyond  question,  is  a  law  of  all  disease. 
Whatever  be  the  nosological  name  of  a  distemper — ague,  epilepsy,  or  erup- 
tion— the  physician  will  more  surely  accomplish  his  purpose  of  cure  by  taking 
advantage  of  this  period  of  immunity,  than  by  any  measures  to  which  he  may 
resort  during  the  paroxysm.  The  more  perfectly  periodic  the  paroxysmal 
return,  the  more  amenable  will  the  disease,  for  the  most  part,  be  to  the 
'chrono-thermal  medicines ;  but  however  imperfect,  irregular,  or  brief  the  re- 
missions, there  is  no  case  of  disorder  that  may  not  be  beneficially  influenced 
by  these  remedies,  whether  they  be  alternated  with  baths  and  emetics,  or  be 
prescribed  in  combination  with  such  symptomatic  medicines  and  local  mea- 
sures as  the  features  of  the  case,  from  place  or  prominence,  may  appear  to 
demand.  Let  us  commence  the  consideration  of  the  chrono-thermal  agents 
with  a  few  observations  on 

The  Peruvian  Bark.— To  the  value  of  this  bark  as  a  remedy  for  many 
diseases,  the  celebrated  Cullen,  among  others,  bears  his  unequivocal  testi- 
mony :  what  does  he  say  are  the  ailments  in  which  he  found  it  most  useful  ? 
Rheumatism,  gout,  scrofula,  scurvy,  small-pox,  dysentery,  gangrene,  diseases 
of  the  bones,  convulsions,  hysteria,  hypochondria,  haemorrhages.  Is  not  this 
a  pretty  comprehensive  association  of  apparently  different  diseases,  all  cured 
or  relieved  by  a  single  substance  !  And  yet  it  never  seemed  to  enter  the 
head  of  an}'  medical  writer  before  me,  that  these  diseases  have  each  some- 
thing in  common — each  some  principle  of  continuity  which,  amid  all  their 
apparent  variety,  establishes  their  unity  of  type.  One  remedy  alleviates  or 
cures  them  all — and  yet  physicians  either  cannot  or  will  not  see  that  the 
action  of  that  remedy  is  one  and  one  only,  viz.,  motive  power.  What  better 
evidence  of  the  absurdity  of  Cullen's  own  nosological  system — a  system  that, 
so  far  from  explaining  the  perfect  continuity  that  pervades  the  chain  of  all 
morbid  motion,  separated  the  link  so  widely  asunder,  that  the  student  could 
not,  for  the  life  of  him,  believe  them  to  be  anything  else  but  so  many  distinct 
and  unlike  disorders,  each  of  which,  forsooth,  required  a  separate  treatise  to 
understand  it !  What  a  beautiful  piece  of  work  for  the  quacks!  what  an 
admirable  method  of  darkening  the  world,  that  bad  men  might  better  pursue 
their  game  of  imposture  ! 

An  accomplished  French  physician,  Baron  Alibert,  speaks  thus  of  the  bark 
and  its  influence  in  disease  :  "  I  have  been  able  to  pursue  and  appreciate  the 
salutary  results  of  the  employment  of  this  substance  in  cancerous  affections, 
in  scrofulous  tumours  of  the  glands,  according  to  the  recommendation  of 
Fordyce  ;  in  many  cutaneous  diseases,  and  principally  in  lepra,  elephantiasis; 
and  in  certain  cases  of  jaundice,  arising  from  diminished  tone  in  the  secretory 
organs  of  the  bile  ;  in  the  alterations  affecting  the  osseous  system,  such  as 
rickets,  spina  bifida,  &c.  With  the  bark,  we  may  also  advantageously  com- 
bat certain  disorders  of  the  nervous  system,  such  as  epilepsy,  hypochondria, 
hysteria,  &c.  Many  authors  recommend  it  in  hooping-cough,  and  tin-  vari- 
ous convulsive  coughs.  No  remedy,  accordjjij  to  them,  is  so  efficacious  in 
strengthening  the  organs  of  respiration,  and  in  preventing  the  state  of  debility 
induced  in  the  animal  economy  by  the  contractile  and  reiterative  movement 
of  the  lungs.  The  most  part  of  those  who  employ  it  in  like  cases  are,  never- 
theless, of  opinion,  that  the  administration  of  11  18  imprudent  without  some 


LECTURE  X.  195 

previous  preparation,  according  to  the  particular  stage  of  disease.  These 
practitioners  (influenced,  doubtless,  by  their  hypothesis  of  a  humour  in  the 
blood)  would  in  some  sort  mitigate  the  ferocity  or  the  paroxysms  by  sweeteners 
and  temperants  ;  often  even  by  evacuants,  such  as  emetics  and  bleedings. — 
To  prevent  irritation,  they  wait  until  the  strength  has  been  absolutely  struck 
down.  But  upon  this  point,  the  celebrated  Murray  differs  from  these  prac- 
titioners in  toto.  The  Peruvian  bark,  according  to  that  physician,  is  equally 
adapted  to  the  cure  of  convulsive  and  periodic  coughs,  as  to  the  cure  of  inter- 
mittent fevers.  He  witnessed  an  epidemic  in  which  these  maladies  were 
efficaciously  met  by  this  powerful  remedy  from  the  commencement.  He 
has,  therefore,  proved  that  there  is  no  advantage  in  retarding  its  adminis- 
tration ;  and  that  to  permit,  in  the  first  place,  so  great  a  waste  of  the  vital 
powers,  only  renders  the  symptoms  more  rebellious,  and  their  consequences 

MORE  FATAL !" 

Gentlemen,  I  am  not  now  giving  you  opinions — I  am  not  now  dealing  in  hy- 
pothetic disquisitions — I  state  facts  simply,  facts  powerfully  attested ;  for  Mur- 
ray in  his  day  was  celebrated  over  all  Europe,  and  Alibert,  only  a  few  years 
ago,  was  second  to  no  physician  in  France.  Both  have  now  passed  from  the 
scene  of  life;  but  their  writings  may  be  still  read  with  advantage  by  every 
one  who  takes  any  interest  in  medicine.  The  value  of  the  bark  in  all  dis- 
eases, both  authors  distinctly  state.  You  have  also  heard  what  they  say  of 
the  sanguinary  practice.  Nothing  can  be  stronger  than  the  expression  of  their 
united  evidence  against  this  practice ;  yet  in  the  teeth  of  that  evidence — in 
the  teeth  of  common  sense  even,  which  says,  that  whatever  reduces  the 
vitality  of  the  whole,  must  more  surely  confirm  the  hereditary  or  other  weak- 
ness of  a  part ;  the  medical  herd  of  this  country  still  go  on  like  their  ignorant 
fathers  before  them,  bleeding,  le'eching,  and  purging  to  death,  or  all  but  death, 
every  unfortunate  creature  who  falls  into  their  hands.  Did  the  disciples  of 
Malthus  only  know  how  admirably  their  master's  system  has  been  carried 
out  by  the  great  body  of  English  practitioners,  what  encomiums  would  they 
not  heap  upon  the  schools  to  whose  regiments  of  lancers  and  leechers  the 
world  is  so  indebted  for  keeping  down  a  surplus  population !  But  let  not 
people  suppose  that,  possessed  of  a  remedy  so  powerful,  and,  so  far  as  no- 
menclature is  concerned,  one  so  almost  universally  applicable  as  the  bark, 
the  physician  has  an  infallible  elixir — a  remedy  adapted  to  all  constitu- 
tions. The  most  perfect  ague-fit  within  my  own  remembrance,  appeared 
to  me  to  be  the  effect  of  two  grains  of  quinine,  prescribed  for  an  asthmatic 
patient.  Dr.  Thompson,  on  the  other  hand,  mentions  the  case  of  a  patient 
of  his,  in  whom  this  medicine  brought  on  an  attack  of  asthma  :  "When  he  was 
getting  well,  after  seven  or  eight  days,  I  again,"  he  says,  "  began  the  sul- 
phate of  quinine,  and  the  same  attack  was  the  result."  A  lady,  after  taking 
it,  became  subject  to  intermittent  fainting-fits.  Now,  some  would  be  glad 
to  lay  hold  of  this  as  a  reason  why  you  should  never  use  quinine.  But  the 
smell  of  the  rose  has  produced  fainting — the  smell  of  ipecacuan  asthma; — 
must  we,  therefore,  never  smell  a  rose,  or  keep  ipecacuan  in  our  houses? 
What  agent  in  nature  is  absolutely  innocuous  ?  Rhubarb,  in  a  very  minute 
dose,  has  produced  convulsions  with  some  people  ;  should  we,  therefore, 
never  prescribe  rhubarb  ?  When  quinine  disagrees,  the  common  complaints 
are  tremor,  faintness,  headache,  vertigo,  nervousness,  cramps,  and  "all-over- 
ishness." Ratier,  in  his  Hospital  Reports,  among  its  deleterious  effects, 
mentions  "  nervous  agitations,"  which,  I  fancy,  might  be  as  well  translated 
•'  shivering-  fits," — or — what  say  you  to  "ague,"  Gentlemen?  Oh  !  you 
may  depend  upon  it,  whatever  can  correct  a  morbid  motion  may  cause  it ! 

Like  many  other  medicines,  the  Peruvian  Bark  is  termed  by  writers  on 
Materia  Medica,  a  tonic.  All  Medicines  are  tonics,  when  they  improve  the 
health  of  the  patient;  but  when,  on  the  contrary,  weakness  or  nervousness 
is  the  result  of  using  them,  who  will  sayi  that  in  that  case  they  are  anything 
but  debilitant  ?     Like  an  emetic,  or  a  purge,  the  Bark  may  do  both  one  and 


196  LECTURE  X. 

the  other.  To  go  on,  then,  day  after  day,  prescribing  this  substance,  and 
what  are  termed  "strengthened,"  without  manifest  amelioration,  or  with 
positive  retrogression,  is  not  giving  a  course  of  "  tonics,"  but  a  succession  of 
exhausting  or  debilitating  agents ;  it  is  to  prescribe  a  name  for  a  name. 

What,  then,  is  the  mode  of  operation  of  the  Peruvian  Bark  when  its  action 
proves  salutary  ?  This  I  conceive  to  be  the  true  explanation.  Whether  it 
be  administered  during  the  Remission  or  Paroxysm,  like  every  other  medi- 
cinal agent  capable  of  influencing  the  corporeal  totality,  the  Bark,  if  it  act  at 
all,  must  do  one  of  two  things,  namely, — Being  a  superadded  motive  power, 
it  must  either,  with  more  or  less  force,  continue,  or  with  more  or  less  force 
reverse  the  direction  of  the  existing  order  of  corporeal  movement,  accord- 
ing to  the  Attractive  or  Repulsive  manner  in  which  it  may  exercise  its  motive 
influence.  Now,  as  this  difference  of  result  depends  upon  whether  the  pa- 
tient's Brain  be  negatively  or  positively  Electric  ;  a  thing  which  can  only  be 
known  by  trial ;  it  must  be  clear  to  every  reflecting  person,  that  where  the 
chances  are  equal  in  favour  of  the  presence  of  either  Electrical  state,  it  is  bet 
ter  to  prescribe  the  medicine  during  the  remissional  movement  of  body,  when, 
so  far  as  continuance  goes,  it  must  act  to  a  certain  extent  at  an  obvious  ad- 
vantage. In  common  with  every  material  agent  capable  of  influencing 
matter  in  motion,  the  power  of  the  Bark,  under  ordinary  circumstances,  must 
be  more  effective  in  continuing  than  in  reversing  existing  motion.  To  reverse 
generally  suggests  opposition,  difficulty,  disadvantage.  To  continue  what  is 
already  begun  as  generally  implies  a  course  of  action  that  can  be  advantage- 
ously undertaken.  The  chances,  then,  being  so  much  in  favour  of  continu- 
ance, it  no  longer  remains  a  question,  which  state  of  body  should  be  selected 
for  the  exhibition  of  the  Bark  ;  the  Paroxysm  or  the  Remission.  Which  of 
these  two  periods  has  most  resemblance  to  Health  ?  The  term  Remission 
at  once  suggests  the  answer  ;  that,  then,  is  the  proper  period  for  the  admin- 
istration of  this  particular  remedy.  And  experience  has  confirmed  what  ex- 
act reasoning  might  have  anticipated  ;  for  when  exhibited  to  the  patient  dur- 
ing the  Paroxysmal  movement,  the  Bark,  for  the  most  part,  not  only  renders 
that  movement  more  intense,  but  prolongs  with  equal  frequency  the  duration 
of  its  period.  A  like  effect  follows  its  administration  during  the  movement  of 
Remission,  for  not  only  in  most  instances  does  it  prolong  this  period,  but  add- 
ing force  to  the  existing  order  of  movement,  it  brings  it  at  last  to  that  desira- 
ble standard  which  it  only  previously  approached,  namety,  the  standard  of 
Health !  Numerous  instances,  of  course,  have  occurred,  where  a  contrary 
effect  has  followed  the  exhibition  of  the  Bark,  both  in  the  case  of  the  parox- 
ysm and  remission.  But  the  general  result  of  its  employment  determines  us 
in  the  line  of  practice  we  should,  under  ordinary  circumstances,  pursue.  So 
long,  then,  as  we  can,  by  the  Bark  or  any  other  agency,  keep  up  the  move- 
ment of  remission  in  as  great,  or  even  greater  force  than  before,  so  long  do  we 
secure  our  patient  from  a  recurrence  of  the  previous  paroxysmal  movement, 
involving,- as  the  latter  must  do,  the  identical  corporeal  matter  of  the  move- 
ment of  remission.  Whatever  be  the  name  or  nature  of  the  disease,  the  re- 
missional movement,  in  most  instances,  though  a  shade  or  two  beneath  that 
of  health,  may,  as  we  have  already  said,  by  the  increase  of  force  effected  by 
the  Bark,  be  brought  at  last  to  the  healthy  standard  ;  nay,  in  some  cases,  by 
a  too  long  continuance  or  an  excess  of  the  medicinal  force  applied,  it  has  it- 
self been  actually  converted  into  a  new  febrile  paroxysm  of  more  or  less  in- 
tensity. But  in  that  case  the  paroxysm  of  the  old  disease  has.  with  equal 
certainty,  been  prevented  from  recurring.  Still,  however  mild  and  subdued 
the  movement  kept  up  by  the  Bark  may  appear,  in  comparison  with  that  of 
the  previous  paroxysm,  it  it  only  be  continued  for  a  sufficient  time,  it  general- 
ly becomes  at  last  so  habitual  as  entirely  to  supersede  the  original  disease, 
and  to  destroy,  as  a  matter  of  course,  the  constitute  agon  which 

th«  recurrence  of  the  old  paroxysm  depended.  Such  constitutional  memory 
French  writers  term  M  memoire  machinale."    It  is  by  this  thut  all  the  motions 


LECTURE  X.  197 

of  health  are  periodically  reproduced — and  by  the  same  law  all  morbid  mo- 
tion takes  on  a  habit  of  periodical  return.  Whatever  will  put  the  Brain  on 
a  new  course  of  thought  or  action,  will  confuse  this  memory.  Hope,  Joy, 
Faith,  and  Enthusiasm  act  in  that  manner.  What  are  these — what  are  all 
passions  but  Fevers  ?  and,  as  no  two  Fevers  can  affect  the  body  at  one  and 
the  same  time,  inasmuch  as  no  given  corporeal  atom  can  move  in  opposite  di- 
rections at  the  same  moment — these  Fevers,  however  mild  in  themselves,  are 
sufficiently  powerful,  in  many  cases,  to  avert  the  return  of  the  more  dangerous 
morbid  motions.  Like  the  fevers  of  pregnancy,  puberty,  &c,  they  may  cure 
or  arrest  every  kind  of  disease  you  can  name,  from  toothache  to  pulmonary 
consumption ;  like  the  same  fevers,  they  have  produced  all ;  according  to 
constitutional  predisposition. 

The  Chrono-Thermal  medicine  next  in  value  to  the  Bark,  is — 
Prtjssic  Acid. — In  its  concentrated  state,  it  is  impossible  to  prescribe  this 
acid.  The  College  of  Physicians  have  therefore  given  a  formula  for  its  dilu- 
tion for  medicinal  purposes  ;  but  I  prefer  that  of  Scheele,  and  I  believe 
most,  other  practitioners  do  the  same.  "  Diluted  Prussic  Acid,"  says  Ma- 
gendie,  "  is  employed  with  success,  in  all  cases  of  morbid  irritability  (weak- 
ness?) of  the  pulmonary  organs.  It  may  be  advantageously  used  in  the 
treatment  of  nervous  and  chronic  coughs,  Asthma  and  Hooping-cough  ;  and 
in  the  palliative  treatment  of  Pulmonary  Consumption  ;  indeed,  a  great  num- 
ber of  observations  induce  the  belief,  that  it  may  effect  a  cure  in  the  early 
stage  of  the  latter  disease.  In  England  it  has  been  administered  with  suc- 
cess in  Dyspepsia,  and  also  in  Hectic  cough  sympathetic  of  some  other  affec- 
tion. [Why  sympathetic  of  another  affection  ?  When  a  man's  health  is 
wrong  throughout,  some  prominent  symptom  is  seized  upon,  and  considered 
to  be  the  cause  of  all  the  others !]  Dr.  Elliotson,  both  in  hospital  and  pri- 
vate practice,  has  frequently  employed  medicinal  prussic  acid,  prepared  after 
the  manner  of  Vanquelin.  He  has  recorded  more  than  forty  cases  of  Dys- 
pepsia, Avith  or  without  vomiting,  and  accompanied  with  considerable  pain  in 
the  epigastric  region,  and  with  p>yrosis,  (water-brash,)  which  were  cured  by 
this  acid.  The  same  physician  quotes  a  case  of  Colica  Pictonum  (spasm  of 
the  colon)  in  which  Dr.  Prout  gave  the  acid,  and  procured  instantaneous  re- 
lief. Dr.  Elliotson  also  administered  hydrocyanic  acid,  in  a  great  number  of 
Pectoral  affections  ;  and  has  almost  invariably  succeeded  in  allaying  the 
troublesome  cough.  [Why  will  people  use  this  word  "  invariably  ?" — what 
agent  in  the  Materia  Medica  acts  invariably  in  the  same  manner  ? — such 
medicine  would  be,  indeed,  a  specific  !  but  that  we  shall  never  discover !] 
Applied  externally  in  lotions,  in  different  diseases  of  the  skin,  it  has  not,  in 
Dr.  Elliotson's  practice,  produced  any  decided  effect.  Dr.  Thompson,  how- 
ever, asserts,  that  he  has  employed  it  in  lotions  with  constant  success  [here 
again,  "constant  success!"]  in  diminishing  the  itching  and  the  heat  so  an- 
noying in  cutaneous  diseases,  and  has  cured  several  species  of  herpe%.' 

"  Mr.  J.  Bouchenel  has  published  an  interesting  memoir  on  the  employ- 
ment of  prussic  acid  in  the  treatment  of  chronic  pulmonary  catarrh.  He 
mentions  four  cases  in  which  this  remedy  proved  effectual.  He  concludes, 
by  urging  that  prussic  acid,  when  given  in  a  small  dose,  is  not  more  inconve- 
nient than  an  ordinary  cough  mixture.  M.  Bouchenel  has  also  employed 
prussic  acid  in  a  case  of  consumption,  but  he  only  succeeded  in  allaying  the 
cough  for  a  time,  which  leads  him  to  doubt  the  fact  of  its  having  really 
effected  the  cure  of  confirmed  consumption.  I  do,  however,  assert  and  main- 
tain (continues  Magendie),  that  with  pirussic  acid  I  have  cured  individuals, 
having  all  the  symptoms  of  incipient  phthisis  :  and.  even  those  in  a  more  ad- 
vanced stage. 

"  In  Italy,  the  medicinal  hydrocyanic  acid  has  been  used  to  allay  exces- 
sive irritability  of  the  womb,  even  in  cases  of  cancer."  "  Professor  Brera 
extols  its  happy  effects  in  pneumonia  ;  he  recommends  it  also  in  rheumatic 
cases,  and  as  a  worm  medicine.     Since  this  professor  has  employed  it  in  dis- 


198  LECTURE  X. 

eases  of  the  heart,  Dr.  Macleod  has  administered  it  in  the  same  diseases. — 
He  has  found  it  allay  nervous  palpitations,  especially  those  which  seemed  to 
depend  on  derangement  of  the  digestive  organs.  [How  common  this  error  of 
accusing  one  symptom  of  being  the  cause  of  another!]  He  has  also  employed  it 
in  some  cases  of  aneurism  of  the  heart.  Dr.  Frisch,  of  Nybourg,  in  Denmark, 
has  allayed  the  intolerable  pain  caused  by  cancer  of  the  breast,  which  had 
resisted  all  the  antispasmodics,  by  washing  the  ulcerated  surface  with  diluted 
prussic  acid.  He  has  also  successfully  employed  the  remedy  in  several  rases 
of  phthisis.  Dr.  Guerin,  of  Mamers,  has  obtained  beneficial  Results  from  its 
employment  in  two  cases  of  brain  fever." 

Thus  far  I  have  given  you  the  experience  of  others  with  this  acid,  as  de- 
tailed in  Magewdie's  Formulary  ;  let  me  now  add  a  few  observations  of 
my  own  in  its  favour.  Combined  with  the  tincture  of  lobelia  injlata,  I  have 
found  it  one  of  the  most  generally  effectual  remedies  for  asthma  with  which 
I  am  acquainted.  The  same  combination  has  enabled  me  to  cure  sjiasmodic 
strictures  of  the  urethra  ;  and,  generally  speaking,  I  have  obtained  successful 
results  from  the  administration  of  prussic  acid  in  cramp  and  spasms  wherever 
developed.  In  the  low,  habitual  fevers,  whether  misnamed  dyspepsia,  hysteria, 
or  hypochondria,  I  have  found  it  particularly  valuable.  I  have  also  expe- 
rienced its  curative  influence  in  the  treatment  of  dropsy :  more  especially 
when  complicated  with  difficult  breathing. 

In  palsy,  I  have  found  prussic  acid  more  generally  successful  than  strych- 
nia. I  may  here  again,  however,  mention,  that  it  is  my  custom,  in  the 
treatment  of  disorder  generally,  to  combine  one  or  more  chrono-thermal 
powers — quinine,  prussic  acid,  or  arsenic — with  one  or  more  symptomatic 
medicines,  those  medicines  possessing  marked  local  influence.  Thus,  one  or 
more  of  the  chrono-thermal  agents  may  be  advantageously  combined  with 
iodine,  in  glandular  and  skin  affections  ;  with  colchicum  or  guaiac  in  rheu- 
matism ;  squill  or  digitalis  in  dropsy  ;  cantharides  or  copaiba  in  leucorrlura  and 
gleet ;  with  squill  in  catarrh  ;  with  purgatives  where  costiveness  is  a  symp- 
tom;  and  so  in  like  manner,  according  to  the  most  prominent  feature  of  a 
case.  Combined  in  this  way  with  tincture  of  ginger,  cardamoms,  Arc.,  I 
have  found  prussic  acid  extremely  valuable  in  the  treatment  of  flatulency 
and  acidity  of  the  stomach.  In  all  these  disorders,  however,  this  and  all 
other  remedies  will  be  found  to  be  advantageous  only  in  so  far  as  they  con- 
tribute to  improve  the  temperature,  and,  consequently,  the  circulation  of  the 
subjects  of  them.  Your  patients,  when  obtaining  their  beneficial  effects, 
will  tell  you,  "  I  have  not  had  those  heats  and  chills  which  used  to  trouble 
me  ;"  or  "  My  hands  and  feet  are  not  so  cold  or  so  burning  as  formerly."  If 
you  poison  a  certain  number  of  rabbits  with  prussic  acid,  say  a  dozen,  and 
pour  cold  water  in  a  stream  over  six  of  them,  these  six  will  recover,  while 
all  the  others  will  die.  This  has  been  done  over  and  over  again  with  the 
same  result.  You  see,  then,  how  clearly  the  influence  of  this  agent  depends 
upon  its  power  of  controlling  temperature. 

We  have  seen  that  prussic  acid  may  be  successfully  employed  in  the  most 
obstinate  agues ;  yet  I  remember  the  case  of  an  Irish  barrister,  who,  from  the 
same  medicine,  experienced  severe  shivering  and  chilliness,  with  cramp,  pain 
of  the  stomach,  and  slight  difficulty  of  breathing ;  the  very  symptoms,  you 
■will  remark,  Gentlemen,  for  which  it  is  so  often  available  in  practice.  The 
electric  condition  of  the  cerebral  part  influenced,  determines  whether  a  given 
remedy  shall  produce  attractive  or  repulsive  motions ;  and  this,  we  have  re- 
peatedly stated,  can  only  be  known  by  trial.  From  such  trial,  no  greater 
harm  than  a  little  temporary  inconvenience  can  take  place  when  pnjssin 
acid  disagrees,  if  prescribed  and  watched  by  a  judicious  physician. — 
Rhubarb  or  magnesia  may  do  the  same,  for,  like  prussic  acid,  both  act 
electrically. 

From  prussic  acid,  I  now  pass  to 

Opium,  and  its  salts  of  Morphia. — These,  like  the  bark,  may  bo  ad- 


LECTURE  X.  199 

vantageously  employed,  as  we  have  already  stated,  in  prolonging  the  interval 
of  remission  in  every  form  of  disease.  Opium,  indeed,  like  every  other  re- 
medy, possesses  more  or  less  influence  over  the  whole  system,  but  its  more 
obvious  effect  is  the  control  which  it  exercises  over  the  nerves  of  the  senses.- 
With  these  we  associate  memory  ;  and  as  every  part  of  the  body  has,  through 
the  brain,  a  power  of  remembrance,  whatever  will  confuse  or  suspend  the 
action  of  the  senses,  will  often  equally  suspend  and  confuse  memory,  and  con- 
sequently conduce  to  the  suspension  or  interruption  of  any  habitual  or 
periodic  action  of  any  part  of  the  body.  A  minute  dose  of  opium  generally 
heightens  the  perceptive  powers,  while  a  large  dose  as  generally  diminishes 
them.  But  a  large  dose,  after  all,  is  only  a  relative  term — for  the  quantity 
that  would  poison  a  horse,  may  be  a  moderate  dose  to  the  habitual  opium- 
eater  ! 

I  do  not  know  a  disease  in  which  I  have  hot  found  opium  useful.  In 
dropsical  cases,  when  administered  at  that  particular  period  of  the  day  when 
the  patients  have  confessed  to  amelioration  of  their  feelings  generally,  it  has, 
in  my  experience,  been  frequently  followed  by  a  copious  flow  of  urine  after 
every  diuretic  had  completely  failed.  By  giving  it  in  a  large  dose,  during 
the  remission,  I  have  kept  several  consumptive  patients  alive  for  months,  and 
some  for  years  even,  whose  existence  must  assuredly  have  been  shortened 
but  for  the  beneficial  influence  of  this  drug.  There  are  persons,  however, 
whom 

Not  poppy,  nor  mandragora, 

Nor  all  the  drowsy  syrups  of  the  world 

would  medicine  into  slumber — but  upon  whom  the  cold  affusion  would  in- 
stantly produce  that  effect.  Behold,  again,  how  much  all  things  depend  on 
temperature !  With  some  people  opium,  as  I  have  already  mentioned,  acts 
like  ipecacuan.  Who  can  tell  what  may  be  the  effect  of  any  remedy  till  it 
be  tried  ?  It  is  only  impostors  who  never  fail  !  As  a  proof  of  the  influence 
of  opium  as  a  preventive  against  disease,  we  are  informed  by  Dr.  M'Pher- 
son,  of  the  Madras  army,  in  his  book  on  China,  that  "  the  peculiar  active 
principle  in  opium,  the  narcotic,  has  of  late  been  employed  with  considerable 
success  in  Bengal,  as  a  substitute  for  quinine.  It  may  also  be  mentioned, 
that  at  the  time  fevers  prevailed  so  extensively  among  our  troops  at  Hong- 
Kong,  but  comparatively  few  of  the  Chinese  suffered,  though  exposed 
throughout  to  the  same  exciting  causes."  And  this  Dr.  M'Pherson  attributes 
to  their  habit  of  opium-smoking.  Travellers,  who  have  witnessed  the  effects 
of  this  drug  in  the  East,  mention  tremor,  fever,  dropsy,  delirium,  and  restless- 
ness, as  the  consequences  of  the  habitual  use  of  opium.  It  has,  nevertheless, 
contributed  to  the  cure  of  all  these  symptoms,  when  produced  by  other  causes. 
In  practice,  we  find  it  give  repose  in  one  case,  and  preclude  all  sleep  in  an- 
other.    It  has  caused  mania,  and  cured  it. 

Very  analogous  to  opium  in  their  mode  of  action,  are 

Alcohol,  Wine,  and  Malt  Liquors;  but  like  every  other  medicinal 
agent,  these  act  upon  the  body  beneficially  or  the  reverse,  in  no  other  man- 
ner than  by  changing  the  existing  temperature  of  the  brain.  If  a  glass  of 
brandy  has  arrested  the  ague-fit  and  its  shudder,  the  army  surgeon  will  bear 
testimony  to  the  "horrors"  and  tremblings  which  the  abuse  of  strong  liquors 
too  frequently  induces  in  the  previously  healthy.  Are  not  the  chill,  the 
shiver,  the  fever-fit,  the  epileptic,  asthmatic,  icteric,  strictural,  and  other 
spasmodic  paroxysms,  daily  produced  by  potation  ?  How  often  have  we 
known  dropsy  brought  on  by  gin  drinking ;  yet  is  not  gin  daily  prescribed 
with  the  best  effect,  for  the  dropsical  ?  See  how  differently  alcohol  affect9 
different  men  !  One  it  renders  joyful  or  gentle  ;  another  sullen  and  morose  ; 
in  a  third,  it  gives  rise  to  wit ;  while  a  fourth,  under  its  influence,  loses  the 
wit  he  previously  possessed.  I  remember  the  case  of  a  man  of  the  First  Re- 
giment of  Foot,  who  grew  mighty  religious,  and  took  to  psalm-singing  every 
time  he  got  drunk.     But  this  sourious  kind  of  godliness,  ks  you  might  have 


200  LECTURE  X. 

expected,  generally  evaporated  with  the  fumes  of  his  liquor.  That  excess 
of  religious  feeling  or  veneration  (as  the  phrenologists  call  it)  does,  however, 
depend  upon  the  temperature  or  motive  condition  of  some  cerebral  part, 
there  cannot  be  a  doubt;  and  that  it  takes  place  by  fits  or  periods,  Shaks- 
peare  well  knew,  for  he  makes  one  of  Clarence's  murderers  say :  *'  I  hope  this 
holy  humour  of  mine  will  change  ;  it  was  wont  to  hold  but  while  one  would 
tell  twenty." 

Wine  will  make  the  brave  man  timid  and  lachrymose — the  coward  capa- 
ble of  actions,  the  mere  thought  of  which,  in  his  sober  moments,  would  have 
inspired  him  with  terror.  One  man  will  first  show  the  effects  of  drunkenness 
in  his  speech — another  in  his  diminished  powers  of  prehension — some  individ- 
uals will  not  betray  the  influence  it  has  obtained  over  them  until  they  try  to 
walk  ;  their  limbs  may  then  fail  them,  though  neither  hand  nor  tongue  show 
any  signs  of  inebriety.  Now  all  this  is  done  by  the  change  of  temperature 
which  wine  induces  on  various  parts  of  the  Brain  of  particular  individuals. 
It  throws  them  into  a  state  of  Fever  ;  and  the  same  phenomena  may  be  wit- 
nessed in  the  course  of  fevers  produced  by  cold  or  a  blow.  Dr.  Jenner,  in 
describing  the  effects  of  excessive  cold  on  himself,  says,  "  I  had  the  same 
sensations  as  if  I  had  drunk  a  coniderable  quantity  of  wine  or  brandy,  and  my 
spirits  rose  in  proportion  to  this  sensation.  I  felt,  as  if  it  were,  like  one  intox- 
icated, and  could  not  forbear  singing,"  &c. —  [Baron's  Life  of  Jenner.]  Take 
the  converse  of  this — A  man  shall  get  as  "  drunk  as  a  lord,"'  and  immediately 
become  sober  under  the  influence  of  a  cold  shower,  or  plunge  bath.  Does  not 
this  unity  of  result  argue  unity  of  mode  of  action  ?  We  prove,  then,  by 
every  possible  manner,  that  the  effect  of  wine,  whether  for  good  or  for  evil, 
like  that  of  every  other  power  in  nature,  relates  to  the  influence  it  exerts  over 
the  Temperature  of  one  or  more  portions  of  the  Brain. 

Musk,  Valerian,  Camphor,  Assafcetida,  have  each  and  all  of  them 
cured  the  ague.  Were  it  not  for  its  expense,  Musk  would  doubtless  be  more 
extensively  used  in  the  practiced  of  medicine.  For  myself,  1  place  it  in  the 
same  rank  with  quinine  and  arsenic  in  the  treatment  of  what  are  termed  the 
purely  nervous  affections.  It  is  generally  recommended  in  books  to  begin 
with  ten  grains  ;  in  my  hands  a  much  smaller  dose  has  been  attended  with  the 
best  effects  in  numerous  cases.  But  a  great  deal  depends  upon  the  purity  of 
the  drug.  I.  lately  succeeded  with  Musk  in  a  case  of  intermittent  Squint 
which  successively  resisted  quinine,  arsenic,  prussic  acid,  and  iron. 

A  married  lady,  who  always,  when  pregnant,  became  the  subject  of  Epi- 
lepsy, but  had  no  fits  under  other  circumstances,  consulted  me  in  her  case  :  I 
tried  every  remedy  I  could  think  of  without  any  advantage  whatever  ;  I 
then  gave  her  Musk,  which  at  once  stopped  the  fits.  The  dose  in  this  case 
was  four  grains. 

We  have  constant  disputes  whether  a  particular  remedy  be  stimulant  or 
sedative.  Opium,  Musk,  and  Prussic  Acid,  have  by  turns  become  the  sub- 
ject of  discussion.  One  theorist  will  take  one  side,  another  another,  and 
each  will  bring  you  facts  of  equal  cogency.  Both  are  right  and  both  are 
wrong.  To  reconcile  this  seeming  paradox,  we  have  only  to  observe  that  all 
remedies  are  either  stimulant  or  sedative,  according  to  the  dose  and  the  con- 
stitution of  the  patient. 

Strychnia  can  both  interrupt  and  produce  Fever.  In  an  experiment  up- 
on a  horse  suffering  from  "  lock-jaw,"  a  watery  solution  of  mux  vomica — the 
well-known  source  of  the  Strychnia — produced,  when  injected  into  the  veins, 
a  shivering  fit  of  some  duration.  I  have,  nevertheless,  found  tin;  sulphate  of 
Strychnia  of  great  service  in  obstinate  agues,  and  in  many  elironic  diseases 
in  which  chilliness,  vertigo,  and  hallucination  or  phantusy  were  symptoms. 
In  the  case  of  a  female  affected  with  nervous  blindness,  for  whom  I  success- 
fully described  sulphate  of  Strychnia,  the  remedy  deprived  bet,  for  about 
an  hour  o  the  u.'>e  of  her  limbs.  The  recovery  of  her  Bight,  under  its  exhi- 
bition, amply  compensated  for  this  temporary  accident.      1  have  found  it  con- 


LECTURE  X.  201 

fuse  the  vision  in  a  similar  manner  when  prescribed  for  muscular  palsies.  In 
the  treatment  of  epilepsy  and  many  other  spasmodic  affections,  this  substance 
may  be  advantageously  combined  with  the  sulphate  of  quinine.  I  have,  not- 
withstanding this,  on  several  occasions,  been  obliged  to  intermit  its  use,  from 
the  pains  of  which  the  patients  complained  while  taking  it  ;  and  this  led  me 
to  make  trial  of  the  remedy  in  rheumatism,  which,  in  some  instances,  it 
cured. 

Silver. — A  consideration  of  the  occasional  beneficial  influence  of  Nitrate 
of  Silver  in  epilepsy,  led  me  to  try  its  effects  in  other  disorders  of  the  spas- 
modic kind,  such  as  asthma,  cramp,  &c,  and  I  am  glad  to  have  it  in  my  puw- 
er  to  bear  testimony  to  its  very  great  value  in  all  of  these  affections.  It  is  a 
powerful  chrono-thermal  medicine — and  like  every  medicine  of  this  class,  it 
can  produce  the  disease  it  can  cure. 

Tremor,  spasms,  palsy,  we  have  seen,  differ  but  in  degree.  In  all  these 
disorders,  Silver  may  be  advantageously  substituted  for  bark,  prussic  acid, 
&c.  While  engaged  in  prosecuting  my  researches  upon  the  medicinal  effects 
of  Silver,  I  found  it  to  be  one  of  the  most  powerful  diuretics  in  the  Materia 
Medica;  a  circumstance  not  altogether  unobserved  by  the  older  authors,  parti- 
cularly Boerhaave,  who  was  accustomed  to  prescribe  it  with  nitre  in  dropsy. 
It  has,  nevertheless,  the  power  to  suspend  the  urinary  secretion.  There  is  an 
affection  to  which  young  women  are  remarkably  subject — a  periodic  pain  of 
the  side — or  stitch.  This  disorder  has  been  maltreated  under  a  variety  of 
names,  according  to  the  notions  entertained  by  attending  practitioners,  as  to  its 
origin  and  nature.  If  practitioners  would  only  take  the  trouble  to  ask  the 
patient  whether  the  affected  side  be  colder  or  hotter  than  natural,  I  do  not 
think  they  would  be  so  forward  as  they  usually  are,  to  order  leeches  and  cup- 
ping-glasses. In  ninety  cases  out  of  a  hundred,  the  sufferer  will  tell  you  that 
that  side  is  always  chilly !  This  at  least  might  convince  them  that  Inflam- 
mation is  not  the  "head  and  front  of  offending."  Such  pain  is  the  result  of 
spasm  of  one  or  more  of  the  intercostal  muscles,  which  pain,  when  the  patient 
is  told  to  inspire,  will  assuredly  increase.  Beware  of  adding  to  it  by  blood- 
letting! In  numerous  cases,  it  will  yield  to  half-grain  doses  of  nitrate  of 
Silver — failing  which,  prussic  acid,  quinine,  or  arsenic,  may  be  successively 
tried  ;  and  to  one  or  other  of  these,  it  will  prove,  for  the  most  part,  amenable. 
In  pain  of  stomach  after  eating — also  a  disease  of  the  spasmodic  kind — I 
have  found  silver  particularly  valuable.  In  all  varieties  of  cough  and  ca- 
tarrh, I  have  derived  advantage  form  its  employment ;  and  I  am  sure 
it  has,  in  my  hands,  contributed  to  the  cure  of  indubitable  phthisis.  Let  it 
be  at  the  same  time  remembered,  that  I  do  not  exclusively  rely  upon  this 
medicine  in  any  one  form  of  disease  ; — for,  unless  it  be  sulphur  for  psora,  I 
do  not  know  a  specific  in  physic. 

There  is  a  disorder  to  which  aged  individuals  and  persons  who  have  suf- 
fered much  from  mental  anxiety  are  liable — a  disposition  to  faint  and  fall — 
often  mistaken,  and  fatally  mistreated,  under  the  name  of  "  tendency  to  apo- 
plexy." The  employment  of  Silver  in  this  affection  has,  in  my  practice, 
been  very  generally  successful.  I  have  found  it  also  decidedly  advantageous 
in  vertigo,  and  in  many  cases  of  mental  confusion. 

Nitrate  of  Silver  has  great  influence  over  the  spine  and  spinal  nerves  ;  for, 
patients  sometimes  complain  of  pains  like  lumbago,  sciatica,  and  rheumatism 
while  taking  it.  I  have  occasionally  known  it  produce  shivering  and  fainty 
sensations,  but  these  inconveniences  were  merely  temporary,  going  off  upon 
the  discontinuance  of  the  medicine.  It  has  cured  them  all  when  produced 
by  other  causes.  You  are  aware  that  blueness  of  skin  is  an  occasional  effect 
of  nitrate  of  silver ;  and  I  must  here  explain  to  you  the  reason.  Most  of 
you  have  seen,  doubtless,  the  pictures  produced  by  light  on  paper  saturated 
with  nitrate  of  silver.  Before  the  nitrate  of  silver  could  turn  the  human  face 
blue,  the  skin,  as  in  the  case  of  the  paper  employed  in  that  process,  must  be 
completely  saturated  with  the  preparation — for   how  otherwise  could  the 


202  LECTURE  X. 

light  affect  the  face  in  that  manner  ?  Though  I  have  myself  prescribed 
nitrate  of  silver  thousands  of  times,  I  never  witnessed  the  slightest  tinge 
from  its  use,  nor  would  any  other,  practitioner  have  to  complain  of  ir  in  this  re- 
spect, if  he  had  not  employed  it  in  too  large  doses,  or  too  continuously.  Who, 
then,  would  reject  a  valuable  remedy,  because  its  abuse  has  produced,  in  rare 
instances,  a  peculiar  colour  of  skin — seeing  that  every  remedy,  if  improperly 
applied,  may  occasion  the  far  greater  calamity,  death  itself! 

Copper,  like  Silver,  is  now  seldom  used  but  in  epilepsy.  Fordycp.  never- 
theless, thought  so  highly  of  it  as  a  remedy  for  Ague,  that  he  ranked  it  with 
the  Peruvian  Bark.  Boerhaave,  Brown,  and  others,  esteemed  it  for  its  diu- 
retic power;  and  accordingly  they  prescribed  it  in  dropsy.  In  the  same  di- 
sease, and  in  asthma,  I  have  had  reason  to  speak  well  of  it,  and  I  can  also 
bear  testimony  to  its  salutary  influence  in  chronic  dysentery — a  form  of  di- 
sease so  frequent  in  the  East  Indies,  that  while  serving  there,  I  had  many  op- 
portunities of  testing  Dr.  Elliotson's  favourable  opinion  of  its  value.  That  it 
can  produce  all  these  disorders  is  equally  true  ;  for  where  it  has  been  taken 
in  poisonous  doses,  "  it  excites,"  according  to  Parr,  "  a  pain  in  the  stomach, 
and  griping  in  the  bowels,  tenesmus,  ulceration,  bloody  stools,  difficult  breath- 
ing, and  contractions  of  the  limbs."  A  universal  or  partial  shiver  will  be 
found  to  precede  or  accompany  all  these  symptoms.  Copper  was  a  favourite 
febrifuge  with  the  older  practitioners. 

Iron  is  a  very  old  remedy  for  ague — perhaps  the  oldest.  Stahl  particu- 
larly dilates  upon  its  virtues  in  this  affection.  Much  of  the  efficacy  of  a 
medicine  depends  upon  the  constitution  of  the  season  and  climate — much  upon 
the  constitution  of  the  patient.  This  metal,  like  every  other  remedy,  has 
consequently  had  its  supporters  and  detractors  in  every  form  of  disease.  It 
is,  at  present,  one  of  the  principal  remedies  for  Hysteria,  and  other  female 
disorders — disorders  which  we  have  already  shown  are  mere  variations  of 
Remittent  Fever.  The  water  in  which  hot  Iron  had  been  quenched,  used  to 
be  prescribed  by  the  ancient  physicians  as  a  bath  for  gout  and  palsy.  In  skin 
diseases  and  cancer,  ricketts,  epilepsy,  urethral  stricture,  &c.j  Iron  has  been 
Taunted  by  numerous  modern  practitioners.  The  ancients  recommended  it 
in  diarrhoea,  dysentery,  dropsy,  hectic,  vertigo,  and  headache.  Now,  in  all 
these  affections,  it  has  served  me  much  like  other  powers — ameliorating  or 
aggravating  the  condition  of  the  patient,  according  to  peculiarity  of  constitu- 
tion. Some  pseudo-scientific  physicians  have  amused  themselves  with  witti- 
cisms at  my  expense,  on  the  subject  of  Iron.  Finding  it  in  some  of  mv  pre- 
scriptions for  Phthisis,  they  have  accused  me  of  mistaking  this  disease  for 
dyspepsia.  How  long  will  men  deceive  themselves  with  such  puerile  ab- 
surdity ?  When  will  they  learn  that  the  human  body,  in  disease,  as  well  a9 
in  health,  is  a  totality, — not  a  thing  to  be  mapped  into  parts  and  portions, 
like  a  field  of  rice  or  corn !  Let  them  take  a  lesson  from  St.  Paul,  who.  in 
his  first  epistle  to  the  Corinthians,  has  these  remarkable  words: — "And 
whether  one  member  suffer,  all  the  members  suffer  with  it :  or  one  member 
be  honoured,  all  the  members  rejoice  with  it."     With 

Zirrc,  Bismuth,  and  their  preparations,  I  have  occasionally  succeeded  in 
prolonging  the  remission  in  many  cases  of  disease,  where  the  other  principal 
Chrono-Thermal  medicines  had  been  ineffectually  tried.  Generallv  speaking, 
however,  they  are  less  to  be  relied  upon  for  this  purpose,  than  those  I  have 
had  so  frequent  occasion  to  mention  in  the  course  of  these  lectures.  The 
successful  employment  of 

Arsenic  by  the  natives  of  India,  first,  I  believe,  induced  European  prac- 
titioners to  try  its  effects  in  ague,  and  also  in  diseases  of  the  skin.  The  happy 
effects  of  this  medicine  were  found  not  to  be  confined  to  these  disorders.  Net 
only  has  its  judicious  administration  been  attended  with  stlccess  in  epilepsy, 
and  numerous  other  forms  of  convulsive  disorder,  but  it  lias  been  advanta- 
geously employed  in  the  treatment  of  structural  change.  Like  every  other 
remedy,  Arsenic  has  its  advantages  and  disadvantages.      Inquire  of  miners, 


LECTURE  X.  203 

exposed  to  the  fumes  of  this  metal,  and  you  will  find  that  Fever,  tremor, 
spasm,  palsy,  and  sores,  compose  almost  the  sum-total  of  their  sufferings.  In 
the  Edinburgh  Medical  and  Surgical  Journal,  there  is  an  account  of  five 
cases  of  poisoning  by  arsenic.  Among  the  symptoms  mentioned  by  the  nar- 
rator, Mr.  Marshall,  were  vomiting,  pain,  and  burning  of  the  stomach,  thirst, 
crural  and  abdominal  spasms,  purgings,  headache,  dimness  of  sight,  intoler- 
ance of  light,  palpitation,  chills  and  flushes,  epilepsy;  all  of  which,  proceed- 
ing from  other  causes,  I  have  successfully  treated  by  Arsenic.  The  first  case 
of  epilepsy  in  which  I  ever  derived  benefit  from  any  remedy,  was  cured  by 
this  metal ;  the  disease  was  principally  brought  on  by  hard  drinking,  and  the 
fit  came  on  at  a  particular  hour,  every  alternate  night.  Now  it  is  worthy  of 
remark,  that  after  an  attempt  at  suicide  by  Arsenic,  detailed  by  Dr.  Roget, 
periodic  epilepsy  was  among  the  effects  produced.  The  subject  of  it,  a  girl 
of  nineteen,  had  also  chills  and  heats,  which,  if  you  please,  you  may  call  In- 
termittent or  Remittent  Fever,  or  anything  else  you  can  fancy — for  it  is  not 
my  custom  to  quarrel  about  names  ! 

As  a  remedy  fgr  skin  disease,  I  have  every  reason  to  speak  highly  of  Ar- 
senic, even  when  complicated  with  much  structural  change.  Some  cases  in 
which  it  had  very  great  effect,  I  will  detail  to  you.  The  subjects  of  them 
were  sepoys,  or  Indian  soldiers,  who  had  suffered  in  the  Rangoon  war,  from 
bad  climate,  defective  food,  and  the  usual  privations  of  men  in  the  field. 
These  patients  were  under  my  care  for  a  fortnight  only ;  and  to  that  period 
the  treatment  refers.  All  of  them,  be  it  remembered,  had  had  "  the 
Fever." 

Case  1 — Jan  Khan,  havildar,  (Native  Sergeant,)  had  diseased  thickening 
of  the  skin  of  the  legs  and  arms.  His  nose  was  enormously  enlarged,  and 
his  whole  appearance  unhealthy.  He  ate  and  slept  badly,  and  his  tongue 
was  foul  and  clouded.  After  the  operation  of  an  emetic,  the  liquor  arsenicalis 
was  administered  in  six  drops  thrice  a-day,  and  its  effects  at  the  end  of  a 
fortnight  were  wonderful.  The  nose  had  then  become  nearly  of  the  natural 
size,  and  the  disease  of  the  skin  had  gradually  lessened.  He  then  slept  and 
ate  well,  and  expressed  himself  much  pleased  with  the  improvement  he  had 
received  from  his  medicine. 

Case  2. — Daud  Khan,  sepoy,  had  pains  of  the  bones  and  joints,  white 
patches  all  over  his  skin,  and  an  irritable  sore  of  the  scrotum,  from  which  a 
fungus,  about  the  size  of  a  chesnut,  sprung  up.  He  complained  also  of  a 
burning  sensation  in  his  feet.  When  I  first  saw  him,  he  was  so  weak,  he 
could  not  rise  from  the  floor  without  assistance,  and  his  countenance  indica- 
ted extreme  wretchedness  and  debility.  Having  removed  the  fungus,  the 
lunar  caustic  was  applied,  and  arsenic  internally  administered,  as  in  the  pre- 
vious*case.  In  a  week,  there  was  great  amendment  of  the  sore.  The  pa- 
tient, since  then,  rapidly  gained  ground ;  of  the  pains  of  the  bones  he  no 
longer  complained,  and  the  eruptions  on  the  skin  gradually  disappeared ; 
the  ulcer  at  the  same  time  closed,  and  I  expected  he  would  soon  be  fit  for 
duty. 

Case  3. — Setarrum,  sepoy,  had  large  sores  of  the  leg,  sloughy,  ill-con- 
ditioned, and  spreading  in  different  directions.  He  had  also  eruptions,  like 
the  last  mentioned  patient ;  and  his  appearance  and  strength,  though  not  so 
wretched,  were  yet  sufficiently  miserable'.  Pure  nitric  acid  was  applied  to 
the  whole  surface  of  the  sores,  and  a  poultice  ordered.  The  arsenic  was 
given  as  above.  On  the  separation  of  the  dead  matter,  the  leg  was  supported 
by  Baynton's  bandage.  The  sore  gradually  healed — the  eruptions  disap- 
peared— and  the  patient  regained  complete  health  and  strength. 

Case  4. — Subryah,  sepoy,  had  had  his  leg  thrice  amputated,  the  last  time 
in  the  middle  of  the  thigh,  but  the  bone  had  been  left  with  only  a  covering  of 
skin.  The  stump  was  in  an  ulcerated  state  when  I  first  saw  him — and  the 
probe,  upon  being  passed  through  one  of  the  sores,  found  the  bone  carious, 
(abraded,)  and  denuded  as  far  as  it  could  reach.     The  patient  was  altogether 


204  LECTURE  X. 

out  of  health,  not  one  function  being  properly  performed.  It  was  proposed 
to  amputate  at  the  hip-joint,  as  it  was  not  believed  that  any  other  treatment 
could  do  good.  To  this  step,  however,  he  woul  J  not  submit.  A  trial  was 
given  to  Arsenic,  and  the  sores,  beyond  expectation,  at  the  end  of  a  fort- 
night had  nearly  healed.  The  patient  then  slept  and  ate  well,  and  looked 
comparatively  strong  and  healthy.     • 

Case  5. — Vencatasawmy,  sepoy,  had  disease  of  the  skin,  and  an  ill-look- 
ing sore  over  the  breast-bone,  which  bone  was  perfectly  carious  ;  the  probe 
could  be  passed  through  it  to  the  depth  of  three  inches  in  the  direction  of  the 
mediastinum.  The  patient  was  weak  and  irritable,  and  could  neither  eat 
nor  sleep  ;  his  pulse  was  rapid  and  small,  and  his  appearance  altogether 
miserable.  Arsenic  was  resorted  to  as  before.  The  ring-worm  under  its 
use,  disappeared ;  the  sore  began  to  look  clean  ;  the  probe,  when  he  went 
from  my  hands,  only  passed  to  the  depth  of  an  inch,  and  the  patient's  health 
was  rapidly  improving. 

These  cases  were  intrusted  to  my  care  by  Dr.  Gibb,  of  the  Madras  Medi- 
cal Staff,  while  he  himself  was  on  "  sick-leave,"  and  we^  afterwards  re- 
ported by  him  to  the  Medical  Board  of  that  Presidency. 

Do  I  now  require  to  tell  you  the  principle  upon  which  arsenic  proved  so 
efficacious  in  the  treatment  of  these  various  structural  changes  ?  It  acted 
simply  by  its  power  of  controlling  remittent  fever,  under  a  chronic  form, 
of  which  these  unfortunate  sepoys  were  all  suffering — the  structural  changes 
being  mere  features  or  developments  of  the  general  derangement. 

Gentlemen,  we  have  now  established,  indisputably  established,  even  by 
the  cases  of  the  schoolmen  themselves,  that  fear,  or  any  other  given  passion, 
bark,  or  any  other  given  chrono-thermal  medicine,  has  each  cured  a  host  of 
maladies,  which  the  authors  of  nosological  systems  not  only  put  down  as 
separate  and  distinct  disorders,  but  to  which  the  profession  usually  ascribe 
a  difference  of  cause  and  nature  ;  some,  according  to  their  views,  being  dis- 
eases of  debility  ;  some,  nervous,  some,  inflammatory.  Now,  connecting 
this  with  the  fact,  that  the  subjects  of  all  these  apparently  different  ailments 
have  fits  and  intermissions,  and  have  each  a  greater  or  less  number  of  the 
symptoms  or  shades  of  symptom  constituting  the  particular  type  of  disorder, 
so  well  known  to  the  vulgar  by  the  term  ague;  for  which,  the  same  vulgar 
are  aware,  there  are  no  powers  so  generally  applicable,  as  bark  and  the  pas- 
sion fear;  to  what  other  conclusion  can  an  unprejudiced  person  come,  than 
that  all  disorders  are  variations  of  this  one  type — that,  abstractedly  speaking, 
there  is  but  one  disease  !  If  this,  then,  be  true — and  its  truth  may  be 
easily  tested  in  every  hospital  in  Europe — am  I  not  justified  in  believing  that 
the  notions  (for  I  will  not  call  them  principles)  which  have  hitherto  guided, 
or  rather  misguided,  physicians  in  their  treatment  of  disease,  are  a  mere  ro- 
mance of  the  schools  ;  that  their  views  of  its  cause  have,  for  the  most  part, 
been  as  erroneous  as  their  modes  of  cure  are  defective ;  and  their  nomen- 
clature and  narrations  throughout,  little  better  than  unmeaning  jargon  ! 

Gentlemen,  I  shall  conclude  these  lectures  with  a  brief  summary  of  the 
doctrines  which  have  occupied  us  during  the  course.  Their  importance  to 
the  human  race,  if  true,  cannot  for  a  moment  be  doubted  ;  if  proved  to  be 
false,  I  shall  be  the  first  to  acknowledge  my  error ;  but,  as  I  said  in  the  out- 
set, I  will  only  appeal  to  results — to  nature.  I  have  proved,  however,  I 
hope  to  the  satisfaction  of  most  of  you,  that — 

1.  The  phenomena  of  perfect  health  consist  in  the  regular  repetition  of 
alternate  motions  or  events ;  each,  like  the  different  revolutions  of  the 
wheels  of  a  watch,  embracing  a  special  period  of  time. 

2.  Disease,  under  all  its  modifications,  is,  in  the  first  place,  a  simple  ex- 
aggeration OT  diminution  of  the  amount  of  the  same  motions  or  events,  and 
beiii'^  universally  alternativt  with  a  pfeniOD  of  comparative  hkm.tm.  strictly 
■peaking,  resoWea  itself  into  kever — remittknt  or  intermittent,  chronic 
or  acute: — every  kind  of   structural    disorganisation,    from  tooth-rf* 


LECTURE  X.  205 

pulmonary  consumption,  and  that  decomposition  of  the  knee-joint,  familiarly 
known  as  white  swelling,  being  merely  "  developments"  in  its  course  : — 
Tooth-consumption — lung-consumption — knee-consumption. 

3.  The  tendency  of  disorganisation,  usually  denominated  acute  or  inflam- 
matory, differs  from  the  chronic  or  scrofulous  in  the  mere  amount  of  motion 
and  temperature : — the  former  being  more  remarkably  characterised  by  ex- 
cess of  both,  consequently  exhibits  a  more  rapid  progress  to  decomposition  or 
cure;  while  the  latter  approaches  its  respective  terminations  by  more  sub- 
dued, and  therefore  slower  and  less  obvious  alternations  of  the  same  action 
and  temperature.  In  what  does  consumption  of  a  tooth  differ  from  consump- 
tion of  the  lungs,  except  in  the  difference  of  tissue  involved,  and  the  degree  of 
danger  to  life,  arising  out  of  the  nature  of  the  respective  offices  of  each  ? 

Disease,  thus  simplified,  will  be  found  to  be  amenable  to  a  principle  of 
treatment  equally  simple.  Partaking,  throughout  all  its  modifications,  of 
the  nature  of  Ague,  it  will  be  best  met  by  a  practice  in  accordance  with  the 
proper  principle  of  treatment  of  that  distemper.  When  the  doctrine  of  the 
Concoction  of  Humours  held  its  baneful  sway  over  the  mind  of  the  physi- 
cian,, it  was  considered  the  greatest  of  medical  errors  to  repel  the  par- 
oxysm ;  each  fit  being  supposed  to  be  a  friendly  effort  of  nature,  for  the  ex- 
pulsion of  a  peccant  or  morbid  humour  from  the  body.  Like  the  popular 
error  of  our  own  day,  so  prevalent  in  regard  to  "  the  Gout,"  it  was  deemed  to 
be  a  salutary  trial  of  the  constitution.  An  ague  in  spring  was  said  to  be 
good  for  a  king !  That  monarchs  occasionally  became  its  victims  at  this  sea- 
son, had  no  particular  share  in  the  revolution  which  has  since  taken  place  in 
medical  opinion.  So  late  as  the  time  of  Boerhaave,  a  physican  asserted,  that 
if  he  could  produce  a  fever  as  easily  as  he  could  cure  it,  he  should  be  well 
satisfied  with  his  own  skill !  The  consequence  of  such  notions  was,  that  the 
practitioner  exerted  his  utmost  to  increase  the  heat  of  the  body  during  the 
paroxysm,  but  the  fearful  mortality  attending  the  practice  had  no  other  effect 
upon  the  mass  of  the  profession,  than  to  make  them  redouble  their  exertions 
in  the  discovery  of  means  of  increasing  this  heat,  that  they  might  thereby  as- 
sist the  unknown  process  which  morbid  matter  was  supposed  to  undergo  !  One 
hundred  years  have  scarcely  elapsed  since  the  fever  patient  was  wrapped  in 
blankets,  his  chamber  heated  by  large  fires,  and  door,  window,  and  bed-cur- 
tain closed  upon  him  with  the  most  scrupulous  attention.  The  few  that 
escaped  this  terrible  ordeal,  were  said  to  be  cured — and  these  Cures,  like 
ignes  fatui,  only  served  to  delude  and  blind  the  practitioner  to  the  awful 
mortality  which  followed  the  practice  ! 

Like  the  present  treatment  of  the  symptoms  still  absurdly  called  Syphilis, 
the  practice  proved  infinitely  more  destructive  to  life  than  the  disease  itself — 
but,  so  far  from  opening  men's  eyes,  the  seniors  of  the  profession,  when  the 
invaluable  Bark  was  first  introduced  to  their  notice,  opposed  it  with  a  vio- 
lence and  a  virulence  only  since  paralleled  by  the  resistance  they  successive- 
ly offered  to  the  introduction  of  the  variolous  and  vaccine  inoculations.  To 
bring  forward  any  sweeping  or  useful  measure  in  Medicine,  requires  a  moral 
courage  and  perseverance  that  fall  to  the  lot  of  few.  The  man  who  wishes 
to  gain  a  ready  notoriety,  has  only  to  puff  off  some  inert  or  mystical  mode  of 
treatment,  and  his  success  is  certain.  He  must  beware  of  coming  before  the 
public  with  a  remedy  to  which  the  stigma  of  poison  can  be  attached.  Does 
not  the  quack  constantly  boast  of  the  absolute  safety  of  his  remedy  ? — See 
with  what  pertinacity  he  contrasts  his  vegetable  medicine  with  the  words 
mineral  poison  ;  which  last  he  uses  for  a  bugbear,  as  if  the  vegetable  world 
was  all  for  a  blessing,  and  the  mineral  all  for  a  bane.  And  the  wonderful 
part  of  this  is,  that  it  answers  admirably,  even  with  what  are  termed  the  ed- 
ucated public — if  those  can  be  educated  who  would  swallow  opium  and  hem- 
lock in  any  quantity  because  they  are  vegetables,  and  who  appear  not  to 
know  that  table  salt  is  a  mineral — that  coal  or  carbon  is  a  mineral — that 
iron  and  lime  are  minerals,  and  that  all  of  these  mineral  substances  actually 


206  LECTURE  X. 

enter  more  or  less  largely  into  the  economy  of  their  own  living  frames  !  To 
sum  up  the  whole,  every  vegetable  substance  is  the  product  of  the  earth  :  and 
if  there  be  truth  in  Scripture— if  there  be  a  statement  in  the  sacred  writings 
more  deserving  of  the  attention  of  the  physician  than  another,  it  is  that  con- 
tained in  the  38th  chapter  of  the  Book  of  Ecclesiasticus,  namely,  that  "  The 
Lord  hath  created  medicines  out  of  the  earth,  and  he  that  is  wise  will  not 
abhor  them  !"  Can  the  man  be  a  Christian  who,  after  this,  would  dare  to 
rave  against  mineral  remedies  ? 

As  now  practised  in  England,  medicine  is  little  better  than  a  copy  of  the 
exploded  navigation  of  the  ancients/  Taking  his  bearings,  less  by  the  ob- 
servation of  the  fixed  stars,  than  by  every  little  eminence  and  prominent  lo- 
cality, the  ancient  mariner,  cautiously,  if  not  timidly,  crept  along  shore. 
With  the  unerring  compass  for  his  guide,  the  seaman  now  steers  his  bark 
boldly  upon  the  boundless  ocean.  Despising  the  localisms  that  formerly 
guided  his  sail,  he  now  completes  his  voyage  to  the  distant  port  in  as  many 
days  as  it  formerly  occupied  him  weeks  or  months.  Keeping  .in  view  the 
principles  here  laid  down,  the  physician  may,  in  like  manner,  with  a  few  rare 
exceptions,  entirely  dispense  with  the  common  anatomical  landmarks  oi'  his 
art — if  he  be  not  startled  with  the  novelty  of  the  light  by  which  we  have  en- 
deavoured to  dispel  the  darkness  that  has  hitherto  clouded  the  field  of  medi- 
cine. Taking  corporeal  Unity  and  Totality  for  his  rudder  and  compass — the 
Brain  and  Nerves  for  the  Ocean  and  Seas  on  which  he  is  to  act — Tempera- 
ture and  R.emittency  for  his  Tide  and  Season — constitution  and  habit  for  the 
rule  by  which  he  must  occasionally  change  his  tack — he  may  now  rapidly 
accomplish  ends  which,  by  groping  among  the  intricacies  of  nomenclature,  or 
by  a  vulgar  attention  to  mere  localities,  he  can  only  imperfectly  attain  by  the 
reiteration  of  long  and  painful  processes ;  he  may  thus,  with  ease,  obviate 
difficulties  which  he  previously  believed  to  be  insurmountable.  Let  him  not 
question  whether  or  not  the  adoption  of  this  will  best  serve  his  own  interest. 
As  physic  is  for  the  public,  not  the  public  for  physic,  he  may  rely  with  cer- 
tainty, that  notwithstanding  the  present  over-crowded  state  of  the  profession, 
the  supply  of  medical  aid  will,  sooner  or  later,  adjust  itself  to  his  own,  as  well 
as  to  the  general  weal. 

It  was  one  of  the  boasts  of  the  eccentric  Radcliffe,  that  he  could  write  the 
practice  of  physic  on  half  a  sheet  of  paper  :  the  whole  might  be  comprised  in 
half  a  line — attention  to  temperature!  This,  you  may  be  sure,  was 
'  Radcliffe's  chief  secret — for  he  was  one  of  the  earliest  physicians  who  first 
introduced  what  is  called  the  cooling  system  in  fever.  When  the  Duke  of 
Beaufort  was  taken  ill  of  the  small-pox,  "the  doctor,"  says  Pottis,  "was 
sent  for,  and  found  his  grace's  windows  shut  up  in  such  a  manner,  by  the  old 
lady  duchess,  his  grandmother's  order,.that  not  a  breath  of  air  could  come  into 
the  room,  which  almost  deprived  the  duke  of  the  very  means  of  respiration. 
This  method  had  been  observed  by  the  physicians  (!)  in  her  grace's  youthful 
days,  and  this  she  was  resolved  to  abide  by,  as  the  most  proper  in  this  con- 
juncture, being  fearful  that  her  grandson  might  otherwise  catch  cold,  and,  by 
means  of  it,  lose  a  life  that  was  so  precious  to  her  and  the  whole  nation.  She 
had  also. taken  a  resolution  to  give  her  attendance  upon  the  duke  in  person 
during  his  sickness,  and  was  in  the  most  violent  consternation  when  Radcliffe 
at  his  first  visit  ordered  the  curtains  of  the  bed  to  be  drawn  open,  and  the 
light  to  be  let  in,  as  usual,  into  his  bed-room.  '  How,'  said  the  ducln -ss, 
'have  you  a  mind  to  kill  my  grandson? — Is  this  the  tenderness  and  affectum 
you  have  always  expressed  for  his  person  ? — 'tis  most  certain  his  grandfather 
and  I  were  treated  after  another  manner,  nor  shall  he  be  treated  otherwise 
than  we  were,  since  we  recovered  [escaped,  truly !]  and  lived  to  a  great  age 
without  any  such  dangerous  experiments  /'  '  All  this  may  fee,'  replied  the 
doctor,  with  his  wonted  plainness  and  sincerity,  '  but  1  must  be  irce  with 
your  grace,  and  tell  yon,  that  unless  you  will  hv(  me  your  word  that  yott'41 
instantly  go  home  to  Chelsea  and  leave  the  duke  wholly  to  my  owe,  !  shall 


LECTURE  X.  207 

not  stir  one  foot  for  him;  which,  if  you  will  do,  without  intermedd/ing  with 
your  unnecessary  advice,  my  life  for  his,  that  he  never  miscarries,  but  will 
be  at  liberty  to  pay  you  a  visit  in  a  month's  time.'  "When  at  last,  with 
abundance  of  difficulty,  that  great  lady  was  persuaded  to  acquiesce  and  give 
way  to  the  entreaties  of  the  duke  and  other  noble  relations,  and  bad  the  satis- 
faction to  see  her  grandson,  in  the  time  limited,  restared  to  perfect  health, 
she  had  such  an  implicit  belief  of  the  doctor's  skill  afterwards,  that  though 
she  was  in  the  eighty-fifth  year  of  her  age  at  that  very  time,  she  declared, 
it  was  her  opinion  that  she  would  never  die  while  he  lived,  it  being  in  his 
power  to  give  length  to  her  days  by  his  never-failing  medicines." 

Well,  Gentlemen,  the  proper  medical  treatment  of  all  diseases  comes,  at 
last,  to  attention  to  Temperature,  and  to  nothing  more.  What  is  the  proper 
practice  in  Intermittent  Fever  ?  To  reverse  the  Cold  stage,  either  by  the 
sudden  shock  of  the  cold  dash,  or  by  the  administration  of  warming  cordials ; 
in  the  Hot,  to  reduce  the  amount  of  Temperature,  by  cold  affusion  and  fresh 
air;  or,  for  the  same  purpose,  to  exhibit,  according  to  circumstances, 
an  emetic,  a  purgative,  or  both  in  combination.  With  quinine,  arsenic, 
opium,  &c,  the  interval  of  comparative  health — the  period  of  medium  tem- 
perature, may  be  prolonged  to  an  indefinite  period  ;  and  in  that  manner  may 
Health  become  established  in  all  diseases — whether,  from  some  special 
local  development,  the  disorder  be  denominated  mania,  epilepsy,  croup,  cy- 
nanche,  the  gout,  the  influenza  !  In  the  early  stages  of  disease,  to  arrest  the 
Fever  is,  in  most  instances,  sufficient  for  the  reduction  of  every  kind  of  local 
development.  A  few  rare  cases  excepted,  it  is  only  when  the  disorder  has 
been  of  long  standing  and  habitual,  that  the  physician  will  be  compelled  to 
call  to  his  aid  the  various  local  measures,  which  have  a  relation  to  the  greater 
or  less  amount  of  the  temperature  of  particular  parts. 

The  Unity  of  Disease  was  first  promulgated  by  Hippocrates,  and  for  cen- 
turies it  was  the  ancient  belief.  In  modern  times  it  found  an  advocate  in  the 
American  physician  Rush — but  except  in  this  instance  of  unity,  betwixt  the 
respective  doctrines  of  both  authors  and  my  doctrines  of  disease  there  is  not 
a  single  feature  in  common.  For,  while  the  first,  from  his  observation  of  the 
resemblance  of  disorders  one  to  another,  inferred  that  one  imaginary  humour 
must  be  the  cause  of  all  complaints — the  doctrine  of  the  second  was  that  all 
disorders  consisted  in  one  kind  of  excitement.  The  principle  of  Hippocrates 
led  him  to  purge  and  sweat; — that  of  Rush,  to  bleed,  leech,  and  starve.  In 
practice  and  in  theory  I  am  equally  opposed  to  both.  Other  physicians, 
doubtless,  have  held  the  idea  of  a  unity  of  disease,  but  neither  in  the  true 
theory  of  the  nature  of  morbid  action,  nor  in  the  principle  of  the  practical 
application  of  medical  resources,  have  I  as  yet  found  the  Chrono-Thermal 
System  anticipated.  The  opponents  of  my  doctrines,  and  those  who  embrace 
them  by  stealth,  have  alike  searched  the  writings  of  the  ancients  in  vain  to 
discover  a  similarity  to  them  in  either  respect.  If  it  be  urged  against  the 
author  of  the  Chrono-Thermal  System  of  Medicine,  that  he  has  availed  him- 
self of  facts  collected  by  others — and  that,  therefore,  all  is  not  his  which  his 
System  contains — I  answer,  Facts  when  disjointed  are  the  mere  bricks  or 
materials  with  which  the  builders  of  all  systems  must  work.  And  to  deny  to 
any  man  the  merit  of  being  the  architect  of  a  great  Edifice  of  Truth  on  that 
account,  would  be  just  as  reasonable  as  to  ascribe  the  merit  of  St.  Paul's 
Cathedral  to  the  donkeys  and  other  beasts  of  burden  Sir  Christopher  Wren 
necessarily  employed  in  fetching  the  marble  and  mortar  composing  it.  "  Merely 
to  collect  facts  is  an  easy  and  mindless  task,  that  any  common  being  can  per- 
form :  it  requires  eyes  and  hands,  and  almost  dispenses  with  a  brain ;  it  is 
the  work  of  a  toiling  wretch,  who,  like  the  miser,  it  incapable  of  using  what 
he  possesses.  Mere  facts  lie  around  even  the  savage,  but  he  knows  not  what 
he  sees — and  such,  precisely  such,  is  the  case  with  the  mere  learners  of  the 
names  of  things,  the  collectors  of  little  facts,  the  undiscriminating  triflers,  who 
think  they  are  cultivating  the  sciences."— [Alexander  Walker.]     It  is  of 


208  LECTURE  X. 

these,  nevertheless,  that  our  medical  clubs  and  coteries  are  chiefly  composed, 
and  it  is  with  the  conglomerating  effusions  of  these  that  the  editors  of  the 
medical  press  chiefly  contrive  to  keep  the  daylight  of  medical  truth  from  the 
eyes  of  the  student.  Microscopical  observations;  straw-splittings,  and  other 
little  facts  you  have  from  their  hands  in  abundance — but  facts  properly  ar- 
ranged and  systematised  into  a  whole  or  great  fact,  not  only  do  you  never  find 
in  their  writings — but  when  you  present  such  great  facts  to  their  eyes,  they 
either  comprehend  them  not,  or  if  they  do,  they  immediately  endeavour  to 
stifle  or  steal  the  discovery.  Out  upon  such  contemptible  creatures,  fit 
only  to 

Suckle  fools,  and  chronicle  small  beer ! 

How  was  the  Chrono-Thermal  System  at  first  received  by  medical  men  ?  I 
speak  not  of  its  reception  by  the  canaille  of  the  profession — the  twaddling, 
intriguing  sycophants  of  country  towns — I  mean  its  reception  by  the  med- 
ical "  aristocracy,"  as  the  Court  doctors  call  themselves.  Immediately  after 
its  publication,  one  of  these  court  gentry  (James  Johnson)  misrepresented, 
ridiculed,  and  denied  it — three  years  after  that,  another  court  physician  (Hol- 
land) attempted,  as  you  have  seen,  by  a  sidewind  to  steal  it — three  years 
more  passed  away,  and  a  third  court  creature  (Forbes)  by  those  meanest"  arts, 
misstatement  and  misquotation,  first  did  his  little  endeavour  to  stifle  it,  and, 
finding  he  could  not  succeed  in  that,  did  what  he  could  to  give  it  to  others. 
If  such  was  the  candid  and  gentleman-like  conduct  of  the  town  doctors,  what 
had  the  Chrono-Thermal  System  of  Medicine  to  expect  at  the  hands  of  the 
physic-selling  profession  in  the  country  ?  What  could  these  intriguing  little 
gossips  do  but  follow  in  the  wake  of  their  town  masters,  the  court  physi- 
cians ?  Now  they  ridiculed  it — now  they  denied  it ;  but  all  the  while  they 
had  no  hesitation  to  practise  it  by  stealth,  some  in  one,  some  in  another  of  its 
fragments.  This  moment  it  was  partially  true,  but  not  new  ;  the  next,  the 
newness  was  admitted,  the  truth  denied.  But,  Gentlemen,  up  to  1836,  when 
I  first  published  the  heads  of  that  system,  the  profession  to  a  man  were  ut- 
terly ignorant  of  the  very  nature  of  disease.  Its  periodicity  in  the  case  of 
ague,  and  a  few  other  disorders,  they  knew — the  periodicity  of  all-  animal 
movement,  whether  in  health  or  disease,  they  knew  nothing  at  all  about — 
and  of  the  mode  in  which  remedies  act  they  were  just  as  ignorant.  As  to 
blood-letting,  which  the  great  majority  of  them  now  admit  they  did  carry  toq 
far,  the  exclusion  of  it  from  the  chrono-thermal  system,  so  far  from  b< 
principal  feature,  as  some  of  them  pretend,  is  only  a  fragmental  part  that  '<i' 
necessity  followed  its  discovery.  I  have  never  taken  credit  for  being  t1. 
opponent  of  the  lancet.  But  one  thing  in  regard  to  this  matter  I  do  claim 
credit  for — I  claim  credit  for  being  the  first  man  who,  by  a  strong  arrav  of 
facts,  and  some  force  of  reasoning,  produced  an  impression  on  the  public  that 
all  the  facts  and  all  the  arguments  of  former  opponents  of  the  lancet  never 
before  produced  on  the  Profession — namely,  an  impression  of  the  dangerous 
nature  of  the  remedy  ;  and  whether  they  like  to  be  told  of  it  or  not,  1  claim 
to  hare  either  convinced  or  compelled  the  profession  materially  to  alter  their 
practice.  How  amusing  to  see  the  manner  in  which  those  who  formerly  ad- 
vocated the  lancet  in  Apoplexy,  now  endeavour  to  get  out  of  their  difficulty  ! 
Sir  C.  Bell,  Clutterbuck,  Marshall  Hall,  Wardrop,  Arc,  in  recent  remarks 
upon  its  treatment,  give  so  many  doubts,  cautions,  and  reservations  as  all  but 
to  amount  to  a  complete  prohibition  of  the  lancet  in  this  disease — not  one  of 
them,  however,  having  the  boldness  to  oppose  it  entirely  in  direct  words,  or 
virtue  enough  to  acknowledge  to  whom  he  owes  the  new  light  that  has  so 
lately  come  upon  him  in  this  matter.  "  Awful  is  the  duel  between  Man  and 
the  Age  in  which  he  lives  !" — Buhccr.  In  all  the  late  medical  reviews  of  my 
writings,  the  subject  of  blood-letting,  which  afforded  so  much  mirth  to  my 
early  critics,  has  either  been  kept  entirely  in  the  bat  k-ground,  or,  it'  m 
at  all,, my  strictures  on  it.  are  declared  to  1"'  a  more  echo  of  the  presenl  opin- 
ions cf  the   profession  !  but  whether  they  be   so  or  nut,  the  astute  editms   >f 


LECTURE  X.  209 

these  publications  determine  that  no  merit  attaches  to  me  for  my  endeavours 
to  put  it  down,  inasmuch  as  it  had  been  equally  opposed  and  decried 
by  somebody  of  some  place  or  another  in  Greece,  who  lived  before  the 
time  of  the  Messiah  !  Gentlemen,  to  Say  blood-letting  is  a  bad  remedy  is 
one  thing — to  Prove  it  to  be  bad  is  another — to  force  the  world  to  believe 
and  act  upon  your  arguments  against  it,  in  the  teeth  of  the  opinion  of  the 
world,  is  a  still  greater  achievement.  That  merit  I  distinctly  claim.  With 
Coriolanus,  I  can  say, 

Alone  I  did  it  ! 

The  silence  and  admissions  of  the  medical  press  on  that  head  equally  attest 
the  fact— while  the  many  barefaced  attempts  to  purloin  my  doctrine  of  the 
Periodic  movement  of  all  Vitality,  whether  in  Health  or  Disease,  is  as  much  a 
compliment  to  the  genius  of  its  real  discoverer,  as  it  is  a  proof  of  the  worth  of 
the  discovery.  On  that  discovery  is  based  the  whole  Chrono-Thermal  Sys- 
tem of  Medicine. 

Before  concluding,  I  will  just  make  a  remark  upon  the  subject  of  the  doses 
of  all  medicines.  Perceiving,  as  you  must  have  done  by  this  time,  the  utter 
impossibility  of  foretelling,  in  many  cases,  especially  of  chronic  disease,  the 
particular  agent  by  which  you  are  to  obtain  amelioration  or  cure, — and  as  in 
almost  every  case  where  an  agent  does  not  act  favourably,  it  does  the  re- 
verse— you  must  see  the  necessity  of  commencing  your  treatment  with  the 
smallest  available  doses  of  the  more  potent  remedies  ;  of  feeling  your  way, 
in  short,  before  you  venture  upon  the  doses  prescribed  by  the  Schools.  Let 
me  not,  for  a  moment,  be  supposed  to  countenance  the  homoeopathic  non- 
sense. The  twelfth  part  of  a  grain  of  calomel,  for  example,  is  a  proper  med- 
icine to  give  to  an  infant ;  but  such  dose  has  no  more  relation  to  the  millionth 
or  decillionth  part  of  a  grain  of  the  same  substance,  than  the  twelfth  part  of 
a  bottle  of  wine — one  glass — has  to  a  drop  of  that  liquid.  The  one  has  pow- 
er to  influence  the  whole  body ;  the  other  is  utterly  inappreciable  beyond  the 
taste  it  may  impart  to  the  tongue,  the  only  organ  it  can,  by  any  possibility, 
even  momentarily  influence.  Gentlemen,  pity  the  Homceopathists  !  shun  the 
Pathologists  and  Blood-takers — and  follow  only  that  best  guide  of  the  physi- 
cian— Nature  !  not  in  the  confined  sense  of  our  mortal  economy,  but  in  every 
department  of  her  works.  One  great  principle  binds  them  together — God 
ia  his  Unity,  pervades  them  all ! 


APPENDIX 


The  following  are  a  few  of  many  letters  which  I  have  received  from  medical 
practitioners  in  various  parts  of  the  globe,  bearing  evidence  to  the  correctness  of  the 
Ghrono-Thermal  System  of  Medicine. 

From  Dr.  M'  Kenzie,  of  Kenellan,  in  Scotland. 

"  Kenellan,  near  Dingwall. 
24th  Feb.,  1841. 
"  Dear  Sir, — After  studying  at  Edinburgh,  London,  and  Paris,  I  graduated  in 
1824,  and  immediately  afterwards  received  an  appointment  to  the  Medical  staff  of 
the  Army.  I  conceive  that,  phrcnologically  speaking,  my  head  is  a  fair  sample  of 
the  common  run ;  and  during  my  period  of  pupilage  I  had  the  very  best  opportuni- 
ty of  acquiring  what  most  people  call  '  medical  information.'  In  the  Military  Hos- 
pital at  Fort  Pitt  I  had  abundant  opportunities  of  testing  its  value,  yet  though  I  did 
my  best  to  put  in  practice  the  rules  and  directions  which  I  had  so  sedulously  stu- 
died in  the  schools  of  medicine,  the  result  of  their  application  was  anything  but  sa- 
tisfactory to  me ;  nor  did  the  observations  I  made  on  the  practice  of  my  comrades 
mend  the  matter.  The  Sangrado  system  was  in  full  operation.  Like  my  neigh- 
bours, I  did  as  I  had  been  taught ;  but  the  more  I  considered  the  result  of  our  prac- 
tice, the  more  convinced  I  became  that  we  were  all  in  the  dark,  and  only  tampering 
with  human  life  most  rashly,  hi  a  multitude  of  cases.  Still,  I  thought  it  my  duty  to 
do  as  my  superiors  directed,  hoping  soon  to  see  my  way  more  clearly.  In  process 
of  time  I  was  appointed  to  a  Regiment,  with  which  I  served  about  two  years.  I 
then  married,  and  finding  that  a  married  man  has  no  business  in  the  army,  I  resolv- 
ed to  embark  in  private  practice,  expecting  that,  with  the  excellent  opportunities 
of  becoming  acquainted  with  disease  in  every  form,  which  I  had  possessed  in  the 
army,  and  aided  by  numerous  friends,  I  might  rise  easily  in  my  profession.  I  set- 
tled in  Edinburgh,  and  became  a  Fellow  of  the  College  of  Physicians.  I  soon 
found,  however,  that  in  leaving  the  army  for  private  practice,  I  was  '  out  of  the  fry- 
ing-pan into  the  fire ;' — there  were  obstacles  to  success  that  I  had  never  even  dream- 
ed of.  In  the  military  hospital  I  had  only  to  say  '  Do,'  and  it  was  done  ;  ami  I  knew 
to  a  nicety  the  effect  of  my  remedies,  for  in  every  instance  they  were  faithfully  ad- 
ministered. In  private  practice  all  this  was  changed.  There,  in  order  to  live  like 
other  men  by  my  labour,  I  found  it  absolutely  essential  to  practise  the  nianfr  in 
■modo  on  many  occasions,  when  the  forfiter  in  re  would  have  been  the  best  for  my  pa- 
tients. I  therefore  felt  myself  obliged  to  consider  how  others  managed  SUCB  mat- 
ters, and  I  was  soon  able  to  divide  the  medical  body  into  threo  classes.  At  the 
top  of  the  tree  I  noted  here  and  there  a  solitary  individual,  whose  word  was  law  to 
his  patients.  I  endeavoured  to  trace  the  career  of  these  favoured  practitioners,  and 
was  grieved  at  being  compelled  to  think  that  in  few  instances  had  they  ascended  to 
their  eminence  by  the  ladder  of  integrity,  talent,  or  real  medical  knowledge.  ;';i 
the  contrary,  I  was  compelled  to  believe  that  these  qualities  often  were  a  bar  to  a 
physician's  rise,  and  that  flattery  and  humbug  were  far  more  valuable  qualities,  iu 
the  eyes  of  the  world,  and,  if  skilfully  practised,  would  ensure  Brat-rate  eminence. 
Lower  down  I  found  a  certain  number  who,  like  myself,  did  their  best  in  retain 
practice,  and  preserve  the  vu&ui  ad  sidera.     Bui  when  l  Looked  to  the 

tree,  I  saw  around  il  a  host  of  creatures,  void  of  any  scruples,  determ  til 


APPENDIX.  211 

wealth,  and  to  act  on  the  ancient  maxim,  rem  si possis  rede;  n  non  quocunque  moda 
rem;  [Make  money, — honestly,  if  you  can;  if  not,  make  money!]  men  who,  void 
of  integrity  and  all  honourable  self-respect,  looked  upon  such  as  differed  from  them 
in  this  point  as  insane.  I  certainly  was  taken  quite  aback,  and  looked,  and  better 
looked,  in  hopes  that  my  senses  deceived  me ;  but  the  more  I  looked  the  more  was 
I  satisfied,  or  rather  dissatisfied  with  the  correctness  of  my  views.  It  was  now 
quite  clear  that  I  never  should  rise  in  the  profession,  and  that,  '  although  bred  to 
physic,  physic  would  never  be  bread  to  me.'  I  could  not  scramble  for  subsistence 
at  the  expense  of  self-respect,  and  live  upon  an  ipecancuan  loaf.  In  spite  of  the  la- 
mentations of  my  friends  and  patients,  who  thought  me  '  getting  on  60  nicely,'  but 
who  were  unable  to  read  my  own  feelings,  and  at  the  expense  of  being  ridiculed 
by  many  who  supposed  me  actuated  by  foolish  pride,  &c,  I  bade  adieu  to  private 
practice,  and  turned  my  lancet  into  a  ploughshare.  In  short,  I  took  to  farming,  in 
which  vocation  I  have  now  continued  for  nine  years,  enjoying  a  happiness  and 
peace  of  mind  that  I  think  few  medical  men  can  understand.  Among  the  poor  I 
still  keep  up  a  little  practice,  and  occasionally  am  consulted  by  my  country  prac- 
tising friends,  but,  like  my  old  lancets,  I  grow  very  rusty.  Perhaps  you  will  say, 
So  much  the  better.  And  now,  why  have  I  troubled  you  with  all  this  from  an  en- 
tire stranger  ?  Simply  as  a  preface  to  the  thanks  that  I  now  beg  to  offer  you  for 
the  new  light  that  broke  upon  me  on  reading  your  work,  which  was  sent  to  me  by 
a  non-medical  friend.  My  ideas  on  physic  have  been  totally  revolutionized  by  it, 
and  I  now  recall  to  my  mind  many  cases  where  I  made  most  fortunate  cures  acci- 
dentally, by  following  your  system,  though  without  any  knowledge  of  the  principles 
of  its  application.  Most  sincerely  do  I  congratulate  you  on  your  discoveries,  and 
most  confidently  do  I  look  forward  to  the  day,  not  distant,  when  they  will  be  duly 
appreciated.  I  have  myself  been  all  but  a  martyr  at  the  shrine  of  Sangrado,  but 
nothing  will  ever  again  induce  me  to  part  with  a  drop  of  blood,  so  long  as  it  will 
circulate  in  the  veins  of 

"Your  obliged  and  faithful, 

"J.  M'Kenzie,  M.D/' 

From  Dr.  Charles  Greville. 

Bath,  Feb.  24,  1841. 
"  My  dear  Sir, — I  have  perused  with  interest  your  excellent  and  original  Lec- 
tures, and  have  much  pleasure  in  attesting  the  troth  of  your  remarks.  I  have  treat- 
ed numerous  cases  of  disease  upon  the  Chrono-Thermal  principle,  with  perfect  suc- 
cess. Should  time  permit,  I  will  furnish  you  with  various  instances.  I  have  no 
doubt  the  public  will  eventually  appreciate  the  superiority  of  your  views,  and  take 
its  leave  of  the  nefarious  apothecary,  whose  existence  seems  to  depend  upon  the 
deluging  of  his  patient  with  unnecessary  and  too  often  deleterious  compounds. 

"  I  remain,  my  dear  Sir, 

"  Yours  very  faithfully, 

"  Charles  Greville." 

From  Mr.  Henry  Smith. 

"  Cheshunt,  Herts,  Feb.  24,  1841. 
"  My  dear  Sir, — At  a  time  when  your  doctrines  are  so  much  the  subject  of  dis- 
cussion, both  with  the  profession  and  the  public,  the  evidence  of  a  country  practi- 
tioner as  to  the  result  of  their  application  in  his  hands  may  not  be  altogether  unac- 
ceptable to  their  author.  The  first  time  I  heard  your  name,  was  about  eighteen 
months  ago,  when  the  Hon.  Edmund  Byng  sent  your  Unity  of  Disease  to  my  father- 
in-law,  Mr.  Sanders.  We  were  both  equally  struck  with  the  novelty  and  simpli- 
city of  your  views,  as  there  detailed,  and  we  determined  to  put  them  to  the  test. 
You  will  be  gratified  to  hear,  that  neither  Mr.  Sandei-s  nor  nryself,  from  that  time, 
have  ever  had  occasion  to  use  either  leech  or  lancet  in  our  practice,  though  for- 
merly we  felt  ourselves  compelled  to  use  both.  E  very  day  has  confirmed  us  in  the 
truth  of  your  opinions  by  our  increased  success.  I,  have  treated  cases  of  Apoplexy 
with  the  most  perfect  success  with  no  other  means  than  the  application  of  .cold  wa- 
ter dashed  over  the  head  and  face, — following  that  up.  after  the  fit  had  gone  off, 
with  quinine,  ammonia,  and  prussie  acid.  I  have  cured  all  kinds  of  cases  of  con- 
vulsion by  the  same  treatment ;  indeed,  m  the  convulsive  d  Besses  of  children,  the 
prussie  acid  has  been  my  sheet-anchor.     In  cases  where  children  have  been  appa- 


212  APPENDIX. 

rently  still-born,  I  have  succeeded  in  rousing  them  by  dashing  cold  water  over  their 
bodies.  With  quinine  and  prussic  acid,  I  have  treated  many  cases  of  cronp,  and 
in  iii»  instance  do  I  remember  to  have  lost  a  patient.  Many  cases  of  hysteria,  and 
some  of  epilepsy,  have  l>eeii  cured  or  relieved  by  creosote,  after  every  other  medi- 
cine had  been  tried  in  vain.  I  have  treat  both  chronic  and  acute  rheu- 
matism successfully  by  arsenic.  By  the  tonic  practice  I  have  been  equally  suc- 
.ijiis  of  the  chest  and  bowels.  Before  concluding  this  hasty 
sketch,  permit  me  to  express  how  tkank/ul  and  grateful  I  feel  towards  you.  for  the 
light  by  which  yon  have  expelled  the  darkness  in  which  medicine  was  formerly  so 
much  enveloped  by  its  prole                             "  Yours,  my  dear  Sir, 

"  Very  faithfully, 

"  Henry  Smith." 

8ince  the  publication  of  the  First  Edition  of  this  Work,  Mr.  Smith  confirms  his 
previous  statement  by  a  further  experience  of  three  years, — five  years  in  all— dur- 
ing which  he  has  not  used  a  leech  or  lancet. 

From  H.  C  Deshon,  Esq.,  Surgeon. 

."  Shroton,  Blandford,  10th  Nov.  1841. 
"  Dear  Sir, — I  have  from  time  to  time  anxiously  waited  to  hear  of  the  state  of 
health  of  that  beloved  relative  [his  mother]  I  left  under  your  care,  and  I  am  now 
glad  to  hear  that  she  considers  herself  better.  *  *  *  I  have  cured  palsy  and 
epilepsy  by  hydrocyanic  acid,  quinine,  arsenic,  &c.,  and  I  have  also  found  these 
medicines  of  avail  in  convulsions  and  dropsies.  Indeed,  I  am  confident  that  most 
diseases  may  be  cured  (1  refer  to  chronic  diseases  chiefly)  by  medicines  useful  in 
ague,  and  on  your  principles,  with  reference  to  Periodicity  and  Temperature. 

"  Dear  Sir,  very  truly  yours, 

•'  Henry  C.  Deshoh." 

From  Charles  Trotter,  Esq.,  Surgeon. 

"  Holmfirth,  near  Huddersfield. 
"  Dear  Sir, — Having  read  the  Second  Edition  of  your  Lectures,   I  have   been  in- 
duced in  a  great  number  of  cases  to  try  the  Chrono-Thermal  system  of  treatment,  and 
I  must  confess  that  in  very  many  instances  it  has  exceeded  my  expectations.    I  have 
cured  what  are  termed  inflammations  without  th  ingle  drop  of 

blood.     Very  recently  I  succeeded  in  bringing  a  case  of  Peritonitis  (inflammation  of 
the  membranous  covering  of  the  bowels)  to  a  favourable  result  without  bl 
at  all.     Several  weU-marfced  cases  of  Pneumonia,  (inflammation  of  the  lungi 
well  ns  of  pure  Bronchitis,  (inflammation  of  the  air  passages,)  have  also  yielded  to 
medicine  without  any  bleeding  whatever.     And  I  may  at  the  same  time  o! 
the  recovery  was  in  every  case  quicker,  and  the  consequent  weakness  less,  than  if 
blood  had  been  drawn. 

"  Yours  truly, 

"  Charles  Trotter.'" 

From  Dr.  Fogarty,  Surgeon  of  the  St.  Helena  Regiment. 

"  London. 
"  My  dear  Sir, — I  have  read  your  Lectures  with  the  greatest  delight.     Every 
word  ought  to  be  written  hi  letters  of  gold. 

"  Yours  faithfully. 

"  M.    KoOARTT." 

From  H.  W.  Bull,  Esq.,  Surgeon,  R.  N. 

uokob  \m.  :>th  F->>..  1843. 

"  Dear  Sir, — I  beg  to  forward  to  at  of  my  own  case,  and  one  or  two 

d  on  your  plan,  all  of  which  are  cvideno  ■■!*  the 

Chrono-Thermal  System.    I  was  attacked  by  paralysis  <     the  !  .1840, 

which  deprivi  .1  me  of  the  use  of  mj  righl  arm  aha  leg,  nffi  i  u  ido  of 

.  and  produced  some  difficulty  of  speech.     Thi  is  adopted, — 

ing,  leeching,  mercury,  aud  blisters.     In  this  state  I  crawled  on  to 


APPENDIX.  013 

May,  1841,  when  I  lost  more  blood  to  prevent  another  anticipated  attack,  goaded  oa 
by  what  you  term  the  bugbear  congestion.  In  this  manner  I  went  on  occasion- 
ally cupping  and  purging,  and  with  a  very  restricted  diet.  In  consequence  of  all 
this,  I  was  much  reduced,  and  I  became  exceedingly  weak, — the  heart  palpitated 
very  mveh  on  the  least  motion,  and  I  had  in  addition  occasional  fainting  fits.  L:i6t 
May,  my  son  sent  me  some  extracts  from  your  Lectures,  the  perusal  of  which  in- 
duced me,  a  few  days  afterwards,  to  state  by  letter  the  particulars  of  my  case  to 
you.  The  first  prescription  you  were  60  kind  as  to  send  disagreed ;  you  then  or- 
dered quinine,  and  this  I  took  with  good  effect.  The  shower-bath  which  you  also 
ordered  I  found  very  beneficial.  I  have  followed  the  plan  laid  down  by  you  with 
very  great  advantage, — changing  the  different  medicines  from  time  to  time  as  occa- 
sion required ;  and  I  can  now  walk  two  miles  without  assistance.  I  have  now  not 
only  power  to  raise  my  right  arm  and  wave  it  around  my  head,  but  I  can  lift  a 
weight  of  forty  pounds  with  it.  I  am  now  following  the  same  plan  with  very  good 
effect ;  I  must  confess  I  was  at  first  startled  by  a  practice  so  very  different  from  all 
I  had  been  taught  in  the  schools,  but  a  practice,  I  can  truly  say,  to  which  1  owe 
my  life.  Like  Dr.  M'Kenzie,  nothing  will  ever  induce  me  to  lose  a  drop  of  blood 
again,  so  long  as  it  will  circulate  in  the  veins  of 

"  Yours  most  sincerely  and  faithfully, 

"  H.  W.  Bull,  Surgeon,  Royal  Navy." 

Cases  alluded  to  in  the  preceding  letter. 

"Case  1. — Mr.  C was  attacked  with  acute  rheumatism  in  almost  every  joint, 

great  difficulty  of  breathing,  and  violent  pain  in  the  chest.  I  prescribed  an  eme- 
tic, but  he  refused  to  take  it, — he  is  a  Hampshire  man.  and  almost  as  obstinate  as 
one  of  his  own  hogs.  He  continued  in  this  state  two  days  more  ;  at  last  he  was  pre- 
vailed on  to  take  the  emetic.  It  operated  soon  and  gave  him  instant  rebel'.  I  fol- 
lowed it  up  with  quinine  and  colchicum :  he  is  now  quite  well,  and  has  gone  to  his 
brother's  house  some  distance  from  this. 

"  Case  2. — A  girl  twelve  years  of  age  was  brought  to  me  from  Binfield  in  con- 
vulsive fits.  The  pupils  of  her  eyes  were  much  dilated,  and  the  fits  followed  each 
other  in  rapid  succession.  I  first  gave  her  a  purgative,  and  followed  it  up  with 
prussic  acid ; — this  was  on  a  Monday.  The  fits  became  less  and  less  frequent,  and 
from  the  following  Friday  they  entirely  ceased.  I  also  lately  used  the  prussic 
acid  with  the  best  effect  in  the  case  of  a  child  seven  weeks  old. 

"Case  3. — A  gentleman  lately  brought  his  child,  a  fine  boy,  to  me,  for  squint ; 
the  age,  two  years.  Some  days  the  boy  squinted  less  than  others.  I  gave  him  six 
powders,  containing  quinine  and  a  little  calomel :  no  other  medicine  was  prescribed. 
There  has  been  no  squint  since  the  powders  were  finished.  In  many  other  cases  I 
have  followed  your  plan  with  the  best  success.  H.  W.  B." 


From  John  Yeoman,  Esq.,  Surgeon. 

"  Loftus,  Yorkshire,  Feb.  2d,  1843. 

"  Sir, — Hearing  that  you  are  about  to  give  us  another  edition  of  your  Lectures, 
I  beg  now  to  offer  to  you  my  bestthanks  for  the  service  you  have  alrendy  done  the 
medical  profession,  by  the  publication  of  your  original  docti-ines  on  disease.  Be- 
ing convinced,  from  my  own  experience  and  observation,  that  there  is  a  Periodicity 
in  most  diseases,  and  that  blood-letting  is  resorted  to,  as  a  curative  measure,  far 
too  indiscriminately,  I  have  read  the  work  with  very  great  interest  and  advantage. 
With  interest,  because  I  have  been  anxious  and  ready,  for  the  last  two  years,  to 
test  the  Chrono-Thermal  doctrine  and  remedies  fairly,  and  with  advantage,  because 
I  have  succeeded  in  a  wonderful  manner  to  care  diseases,  by  acting  up  to  the  prin- 
ciples and  practice  you  recommend.  I  have  treated  several  cases  of  decided  Pie u- 
risy  and  Pneumonia  according  to  the  Chrono-Thennal  System,  using  emetics,  purga- 
tives, tartar  emetic,  prussic  acid,  and  quinine,  and  without  the  aid  of  lancet  or  blis- 
ter, most  successfully.  In  croup  and  typhus-fever,  I  can  bear  ample  testimony  to 
the  good  effects  of  emetics,  cold  affusions,  prussic  acid,  and  quinine;  and  with  these 
agents  alone,  I  have  cured  several  cases  of  both  within  the  last  six  months.  You 
are  at  liberty  to  make  use  of  these  few  remarks,  to  make  them  known  to  the  pro- 
fession, or  the  world,  as  you  please  :  and  wishing  you  every  success  in  your  fu- 
ture efforts,  good  health,  and  happiness,  "  I  am.  Sir,  yours  sincerely, 

"  John  Yeoman." 

"  Member  of  the  Royal  College  of  Surgeons,  and  Licentiate  of  the  Apothecaries' 
Company,  London." 


214  APPENDIX. 

From  Dr.  Sprague,  formerly  a  Medical  Officer  on  the  Staff. 

"  Clevedo.v,  near  Bristol,  Feb.  6tk,  1843. 
"  My  dear  Sir, — Having  read  over  and  over  again  your  invaluable  work,  and 
having  devoted  much  time  to  the  study  of  the  principles  laid  down,  I  am  desirous 
to  convey  in  plain  language  my  sentiments  in  regard  to  the  immense  benefit  which 
would  indubitably  be  conferred  on  mankind  by  the  general  adoption  of  your  opi- 
nions and  practice.  I  was  strictly  educated  to  the  Medical  profession  from  my 
youth  up,  and  have  been  in  actual  practice  more  than  thirty-threk  years. 

"  Notwithstanding  the  6trenuous  and  persevering  advocacy  with  which  blood-let- 
ting has  been  so  universally  urged,  and  that,  too,  hi  the  face  of  the  great  destruc- 
tion of  human  life  indubitably  produced  by  it,  to  you,  sir,  belongs  the  honour  of 
triumphantly  proving  by  evidence  the  most  incontrovertible,  that  '  all  diseases 
which  admit  of  relief  can  be  successfully  treated  without  loss  of  blood.'  And 
here  do  I  most  willingly  record  my  unbiased  testimony  to  this  important  Truth. 
Let  me  further  add,  that  by  a  course  of  patient  investigation  and  much  practical 
experience,  I  had  arrived  at  the  same  conclusion  before  I  had  the  pleasure  of  pe- 
rusing your  writings.  I  am,  therefore,  bound  to  acknowledge  how  highly  I  value 
the  moral  courage  which  has  induced  you  to  promulgate  your  invaluable  opinions, 
and  which,  I  believe,  are  built  upon  an  immovable  foundation.  With  a  deep  6ense 
of  obligation  to  you  for  the  information  1  have  derived  from  your  various  writings. 

"I  remain,  yours  faithfully, 

"J.  H.  Sprague  " 

From  John  P.  Baldy,  Esq.,  Surgeon. 

"  Devosport,  3d  March,  1843. 
"  Dear  Sir, — I  have  for  several  years  past  followed  a  similar  line  of  practice  to 
yourself;  but  I  must  confess  I  never  entered  so  deeply  into  the  principles  of  it  till 
I  read  your  invaluable  publication.  If  medical  men  would  follow  your  steps — the 
steps  of  nature — instead  of  the  theories  of  the  schoolmen,  mankind  would  be  be 
nefitted,  and  you  would  be  hailed  as  the  Founder  of  a  New  System  of  Physic ;  and 
your  name  would  go  down  to  posterity  with  those  immortal  men,  Harvey  and  Jen- 
ner.  "  I  remain,  dear  Sir,  yours  faithfully, 

"John  P.  Baldy,  M.R.C.S." 

From  Dr.  Carter,  of  Reading. 

"  Beading,  Oct.  2Qtk,  1843. 
"I  am  proud,  my  dear  Sir,  to  acknowledge  you  as  my  father  in  rhysic.     From 
1829  to  1838,  I  went  through  the  course  of  my  medical  education  after  the  most 
approved  orthodox  fashion,  and  I  fancied  I  comprehended  the  practice  of  medicine. 
Your  views  too  clearly  point  out  that  I  was  more  than  ignorant  on  the  subject. 

"  I  find,  on  referring  to  my  note-book  of  cases,  that,  since  February,  1842,  up  to 
the  present  date,  nearly  three  hundred  medical  cases  have  occurred  in  my  practice 
— cases  of  acute  and  chronic  disease.  In  the  treatment  of  these,  I  have  strictly 
followed  the  Ghrono-Thermal  principles,  and  I  feel  a  conscious  satisfaction  and  de- 
light when  I  reflect,  that,  with  the  exception  of  one  case,  (Phreuitis,)  my  treatment 
— your  treatment — has  restored  them  all  to  health.  Which  of  our  greatest  doctors, 
by  the  old  treatment,  can  boast  of  a  similar  successful  result  ? 

"  Yours  very  faithfully, 

"Matthew  Garter,  M.R.C.P." 

From  C.  Don,  Esq.,  Assistant  Surgeon,  7th  Madras  Native  Infantry. 

"  Kamptkk,  23d  March,  1844. 
"  My  dear  Sir,— I  hope  you  will  excuse  the  liberty  of  a  stranger  to  you  writing 
a  few  lir-es.  It  is  simply  to  return  you  my  best  thanks  for  the  great  gratification  J 
have  had,  and  still  have,  in  reading  your  highly  original  Lectures,  1  bave  a  sitter 
goin^'  home  from  Bengal  in  bad  health,  and  I  have  advised  her  to  put  In  irself  under 
your  care,  hoping  you  will  be  able  to  do  her  good. 

"  I  remain,  my  dear  sir,  yours  very  truly, 

"C.  Dos, 
"Assistant  Surgeon,  7  th  M.NL' 


APPENDIX.  215 

Dr.  Dickson  and  Dr.  Forbes. 
To  the  Editor  of  the  Medical   Times. 

3rd  January,  1843. 

Sir, — Will  you  allow  me,  through  the  medium  of  your  pages,  to  administer  a 
little  wholesome  castigation  to  Dr.  John  Forbes,  of  British  and  Foreign  Medical  Re- 
view notoriety  ? 

In  the  present  January  number  of  that  periodical,  Dr.  Forbes  pretends  to  review 
the  second  edition  of  the  "  Fallacies  of  the  Faculty."  The  very  first  quotation 
from  the  volume,  in  his  first  page,  is  a  misquotation  !  The  second  quotation  in  the 
same  page  is  a  misquotation !  The  first  quotation  in  the  next  page  is  a  misquotation ! ! 
At  the  bottom  of  his  third  page  is  the.  following  false  insinuation; — "  Curved  spine, 
which  Stromeyer  and  a  few  other  insignificant  schoolmen  have  attributed  to  para- 
lysis of  certain  sets  of  muscles,  is  also,  in  the  opinion  of  Dr.  Dickson,  a  remittent 
affection."  Certainly,  at  the  commencement,  it  is  a  remittent  affection;  but  in  the 
very  volume  my  critic  pretends  to  review,  not  only  do  I  take  much  pains  to  prove 
its  paralytic  nature,  but  I  claim  to  myself  the  discovery  of  that  fact ;  and  if  Dr.  Forbes 
chooses  to  appeal  to  dates,  I  will  make  it  clear  to  the  world,  that  Stromeyer  and  his 
other  schoolmen  have  only  followed  in  my  wake ! 

As  a  specimen  of  the  misquotations  I  have  noticed  in  this  pretended  review,  take 
the  following  : — In  the  original,  the  passage  stands  thus,  "  Like  every  other  reme- 
dial agent  it  (iodine)  cuts  two  ways — atomically  attracting  or  lessening  volume  and 
secretion  in  one  case,  atomically  repelling  or  increasing  both  in  another,  according 
to  the  electric  state  of  the  individual  body  for  which  it  may  be  prescribed."  In  the 
misquotation,  the  word  "  anatomically"  is  substituted  in  both  instances  for  "  atomi- 
cally." Dr.  Forbes  asks,  if  this  be  not  stark  staring  nonsense?  Most  certainly; 
but  it  is  his  nonsense,  not  mine.  Perhaps,  Dr.  Forbes  will  ascribe  these  and  his 
other  misquotations  to  the  printer's  devil — six  misquotations  at  least  in  a  review  of 
as  many  pages !  Such  a  course  was  worthy  of  the  plagiarist  of  Dr.  Paine  [for  a  full 
account  of  which  disgraceful  transaction,  see  the  various  Medical  Journals.]  Yet 
he,  Dr.  Forbes,  has  the  impudence  to  tell  his  readers,  "  We  have  done  justice  to  his 
[Dr.  Dickson's]  doctrines,  by  giving  them  and  the  proofs  in  his  own  language." — 
He  concludes  his  review  by  asking,  "  Has  not  Dr.  Dickson  made  an  Ass  of  himself  1" 
In  return  for  which  piece  of  politeness,  I  ask  you,  Mr.  Editor,  if  Dr.  Forbes  has  not 
made  a  Knave  of  himself?  Dr.  Forbes  is  a  Court  Physician,  "Physician  Extraor- 
dinary," &c. ;  so  is  his  friend  and  coadjutor,  Dr.  Holland.  Perhaps  it  is  by  way  of 
revenge  for  my  having  defeated  Dr.  Holland's  ingenious  attempt  to  steal  my  dis- 
coveries, that  Dr.  Forbes  now  does  his  best  by  an  equally  ingenious  device  to  stifle 
them.     The  world  will  doubtless  cry,  "  Arcades  ambo !" 

I  am,  Sir,  your  obedient  servant, 

S.  Dickson. 


Dr.  Dickson  and  Dr.  Laycock. 

To  the  Editor  of  the  Medical  Times. 

July  20,  1842. 
Sir, — I  beg  to  express  to  you  my  obligation  for  your  early  insertion  of  my  letter, 
on  the  subject  of  Vital  Periodicity,  and  I  would  further  beg  to  tender  my  very  best 
thanks  to  the  numerous  friends  who,  in  your  pages,  have  as  kindly  and  readily  come 
forward  to  vindicate  my  claim  to  the  discovery  of  the  doctrine  in  question.  That 
fragmentary  parts  of  the  doctrine  of  Vital  Periodicity  should,  from  time  to  time,  have 
attracted  the  attention  of  medical  theorists,  will  excite  the  wonder  of  nobody — no- 
body at  least  that  had  ever  counted  a  pulse,  or  witnessed  in  his  life  the  outward 
phenomena  of  an  ague — nobody  even  who  knows  so  much  of  man  and  his  many 
diseases,  as  to  be  aware  that  his  toothache,  his  tic,  his  gout,  and  his  epilepsy,  come 
on  in  fits  only,  and  by  no  possibility  can  last  for  ever !  Hippocrates,  Celsus,  Boer- 
haave,  Darwin,  ay,  and  hundreds  of  others,  knew  this  much  at  least ;  some  trying  to 
explain  it  one  way,  some  another.  M'Culloch  more  recently  and  more  fully  handled 
the  subject,  and  he  endeavoured  to  prove  what,  for  a  time,  scarcely  one  professional 
man  in  Europe  doubted — that  every  intermittent  action  depends  on  malaria  or 
marshy  emanations.  This  doctrine  of  M'Culloch  I  wa3  the  first  to  impugn  ;  and  I 
have  yet  to  learn  that  any  author,  ancient  or  modern,  in  England  or  elsewhere,  has 
preceded  me  in  the  discovery,  fiat  all  the  movements  of  all  animal  bodies — the 
greate:-  and  the  less — the  atomic,  Junctional,  and  organic — whether  in  health  or  dis- 


216  APPENDIX. 

ease — disease  however  caused — like  all  the  movements  of  all  the  systems,  minor  and 
major — of  the  universe  at  large — are  similarly  intermittent  and  periodic  !  And  that 
there  can  be  no  more  an  eternal  or  continuous  disease  (i.  e-  a  disease  without  inter- 
mission) than  there  can  be  an  eternal  earthquake,  or  an  eternal  tempest.  Six  years 
ago  and  more,  I  brought  this  forward — this  doctrine  of  the  periodic  and  intermittent 
nature  of  all  animal  movement — not  as  a  whole,  but  as  a  part;  for  with  it  1  also 
published  the  Elements  of  the  New  System  of  Medicine,  which  necessarily  grew 
out  of  the  discovery,  viz.,  the  Chrono-Thermul  System.  And  how  were  my  dis- 
coveries then  received  at  the  hands  of  the  professional  public  ?  How  !  How,  Mr. 
Editor,  did  the  professional  public  ever  receive  any  discovery  that  improved  the 
practice  of  physic  ?  Mine  they  received  as  they  have  received  every  other.  So 
far  back  as  1836,  I  demonstrated  that  life  in  health  is  in  reality,  and  not  figuratively, 
a  "  fitful  fever" — a  thing  of  alternate  motion  and  rest — alternate  chill  and  heat — de- 
pression and  excitement — and  that  intermittent  fever  or  ague  is  the  type  or  model 
of  every  one  of  the  many  modifications  of  life  termed  disease.  Then  the  doctrine  was 
scouted  and  ridiculed  by  all.  Doctors,  surgeons,  apothecaries,  all  flew  to  arms. — 
The  reviewers,  in  the  language  of  Dr.  James  Johnson,  their  chief,  denounced  it  as 
a  FEVER-madness — a  PYRExr-mania.  Nobody  then  dreamed  of  calling  its  author' 
ehip  in  question.  No!  it  was  false,  fanciful,  and  fatuous  throughout — so  utterly  in- 
sane, that  nobody  ever  was  mad  enough  to  put  such  madness  on  paper  before ! — 
How  stands  the  question  now  ?  Why,  it  makes  one  laugh  at  the  turn-coat  world  ; 
for  who  could  dream  that  the  same  men  who,  six  years  ago,  denounced  the  author 
as  a  madman,  and  his  system  an  absurdity,  would  now  meanly  attempt  to  annihilate 
and  cast  aside  the  one,  while  adopting  as  then-  own  the  principles  of  the  other ! — 
This,  nevertheless,  has  been  done.  But  you,  Mr.  Editor — of  you  I  demand  why 
you  only  do  me  partial  justice?  "  Whoever,''  you  say,  "  preceded  Dr.  Dickson,  Dr. 
Dickson  long  preceded  Drs.  Holland  and  Laycock.  In  publishing  the  doctrine  in 
England,  and  having  done  much  to  revive  and  propagate  it,  he  was  fairly  entitled 
to  some  notice  by  more  recent  writers  adopting  his  views  on  so  important  a  sub- 
ject." Of  whose  doctrines,  Sir,  permit  me  to  ask,  are  mine  a  REVIVAL?  Who, 
before  me,  maintained  the  doctrine  of  the  Periodicity  of  all  Animal  Life  ?  I  speak 
of  Life  in  its  totality — its  abstract — not  in  its  fragments !  It  is  only  in  the  nature  of 
things,  that  a  doctrine  when  reluctantly  admitted  to  be  true,  should  be  whispered 
away  as  not  new;  and  you — you,  Sir,  doubtless,  in  my  case,  have  unwittingly  caught 
up  the  echo!  The  same  thing  happened  to  Harvey.  When  his  enemies  found  it 
impossible  any  longer  to  deny  the  truth  of  his  discovery,  they  accused  him  of  having 
stolen  it  from  the  ancients.  Ancient  or  modern,  what  author  have  /  stolen  from  ! 
Who  taught  me  that  all  diseases,  however  named,  and  by  whatever  caused,  ara 
intermittent  in  their  character;  or  that  all  diseases,  like  the  ague,  may  be 
cured  on  the  principle  of  prolonging  the  intermission,  by  bark,  arsenic,  opium, 
&c.  ?  To  whom  am  /  indebted  for  the  hint,  that  every  and  each  of  these  medi- 
cinal agents,  like  every  other  medicinal  agent  in  nature,  cause  and  cure  by  their 
electrical  influence  6olely — in  one  case  electrically  producing,  in  another  electrically 
reversing  every  morbid  motive  condition  of  the  body?  That  whether  opium  pro- 
duce sleep  or  wakefulness;  whether  copaiba  aggravato  or  cure  discharges;  whether 
prussic  acid  or  strychnia  cause  or  relieve  palsy,  spasms,  &c.,  depends  upon  the  posi- 
tive or  negative  electrical  state  of  the  brain  of  the  individual  selected  for  their  admi- 
nistration? That  change  of  temperature  and  change  of  motion  are  equally  the  law 
of  disease,  remedy,  aud'eause?  Who,  I  again  demand,  taught  me  these?  Of  these, 
nevertheless,  and  many  other  matters  which  have  never  entered  the  bead  of  potho» 
logical  professors,  the  Unity  of  Disease  and  Falla,  tUy  treat  at  length. — 

Under  the  title  of  Errcnr  de  Midecau,  mi  Sysld.me  Chrono'hcrmtitc,  the  latter  work  is 
now  busily  agitating  the  medical  circles  of  Fiance  and  Germany.  Permit  its  author 
to  ask  why  you  have  not  reviewed  it?  In  the  expectation  that  you  will  still  do 
your  duty  in  this  respect  to  your  readers,  he  looks  forward  to  a  "just  and  candid 
criticism  at  your  hands.  Your  very  obedient  servant. 

S.  Dickson. 
This  letter  the  Editor  of  the  Medical  Times  declined  to  insert.     Hut  short  K 
wanU  a  "  Review"  of  the  Fallacies  of  tlic  Faculty  appeared    in  his   page*. — which 
Review,  while  it  nibbled  at  certain  fragmentary  matter,  discreetly  postponed  iiM 
die  all  notice  of  the  doctrine  of  the  Uiaty  of  D*itaa§,  and  more  partioularl)  i 
to  answer  the  question— Whom  have  I  Rj  . 

Scarcely  was  the  People's  Edition  of  this  work  published,  when  the  same  indi- 
vidual who,  in  June,  with  his  ''discoveries*' 
on  Vital  Periodicity— Dr.  Laycock,  of  York— ventured  to  put  forth  something  more 


APPENDIX.  217 

in  the  same  oi-iginal  vein  in  the  Lancet ;  and  among  other  things,  to  "prevait  con- 
troversy" he  claimed  to  have  discovered  the  periodic  movement  of  all  vitality  !  Im- 
mediately on  seeing  this,  I  wrote  to  the  Editor  of  the  Lancet,  charging  Mr,  Lavcock 
with  piracy;  sending  at  the  same  time  a  copy  of  the  Fallacies  of  the  Faculty,  that 
the  respective  dates  of  his  and  my  papers  might  be  compared.  Instead  of  printing 
my  letter,  Mr.  Wakley,  the  Editor,  in  a  note  to  correspondents,  informed  me  that 
my  work  would  be  examined  in  connexion  with  the  paper  of  Dr.  Laycock,  and  his 
[Mr.  Wakley's]  opinion  of  the  epiestion  raised  by  me,  given  in  another  number. 
I  immediately  wrote  to  say,  I  would  dispense  with  his,  Mr.  Editor  Wakley's  opinion, 
if  he  would  do  me  the  favour  to  print  my  letter.  What  was  the  reply  o{  this 
second  Daniel — this  exquisite  expounder  of  Crowner's  Quest  law  ?  "  We  have 
received  the  second  note  of  Dr.  Dickson — who  may  adopt  any  course  that  he  thinks 
proper,  though  he  may  be  assured  that  we  shall  not  allow  him  to  make  use  of 
the  columns  of  this  journal  for  promulgating  a  charge  of  piracy  against  a  highly  re- 
spectable physician,  unless  he  accompanies  that  charge  with  proofs  of  the  accuracy 
of  his  allegation — [the  first  time  he  asks  for  what  he  has  already  got — proofs!] — 
The  subject  is  in  progress  of  investigation,  and  a  perfectly  fair  and  just  decision  shall 
be  the  result." 

Anticipating  the  sort  of  investigation  Mr.  Editor  Wakley  intended,  I  immediately 
dispatched  the  following  to  his  address,  taking  care,  at  the  same  time,  to  send  a  copy 
to  the  Medical  Times,  where  it  was  in  due  time  inserted : — 

To  the  Editor  of  the  Lancet. 

April  22,  .1843. 
Do  not,  Sir,  imagine  that  any  trick,  or  artifice,  however  ingenious,  can  juggle  me 
out  of  a  discovery  which  it  has  been  the  labour  of  my  life  to  establish — the  discovery 
of  the  Periodic  movements  of  all  Vitality — of  the  periodicity  of  life  in  health — the 
periodicity  of  life  in  disease — of  the  periodicity  of  movement  of  universal  nature ! 
You  will  not,  you  say,  allow  me  to  make  use  of  the  columns  of  your  journal  "  for 
promulgating  a  charge  of  piracy  against  a  highly  respectable  physician,  unless  1 
accompany  that  charge  with  proofs  of  the  accuracy  of  my  allegation ;"  and  in  the 
same  breath  you  add,  "  The  subject  is  in  process  of  investigation,  and  a  perfectly 
fair  and  just  decision  shall  be  the  result."  What!  an  investigation  and  decision 
■without  proofs !  Not  Mr.  Thomas  Wakley  surely,  but  some  blockhead  of  an  under- 
ling, must  have  penned  that  absurdity.  Proofs !  What  proofs  do  you  demand  ? 
words?  dates?  or  both? — words,  or  dates,  that  the  papers  recently  printed  and 
eulogised  by  you  under  the  head  of  "  Vital  Periodicity,  by  Dr.  Laycock,"  are  so 
many  mean  attempts  to  plagiarise  my  doctrine  of  the  periodic  movement  of  all 
vitality  !  Sir,  the  proofs  are  already  in  your  possession ;  they  are  contained  in  my 
works,  the  Fallacy  of  Physic  as  taught  in  the  Schools ;  the  Unity  of  Disease,  and 
Fallacies  of  the  Faculty,  1st,  2nd,  3rd,  and  foreign  editions ;  nay,  they  are  stamped, 
indelibly  stamped,  on  your  own  pages  !  Look  to  the  Lancet  for  23rd  Sept.,  1837,  and 
you  will  there  find,  what  Mr.  Laycock  now  so  modestly  puts  forth  as  his,  the  whole 
doctrine  of  Vital  Periodicity  given  by  myself.  Let  me  quote  it : — "  The  principal  aim 
of  my  volume  [Fallacy  of  Physic,  &c,  published  in  1836]  has  been  to  demonstrate, 
that  the  corporeal  actions  of  man  in  his  healthy  state  constitutes  the  basis  or  standard 
of  every  kind  of  living  action.  In  health  he  rests  from  his  labour— he  sleeps — he 
wakes  to  sleep  again — his  lungs  now  inspiring  air,  now  expelling  it ;  his  heart  succes- 
sively dilating  and  contracting ;  his  blood  brightening  in  one  set  of  vessels  only  again 
to  darken  hi  another — his  food  and  drink  nutritious  one  hour  to  become  excrementi- 
tious  the  next — in  a  word,  all  his  appetites  and  necessities  periodically  alternating 
with  each  other."  Nor  do  I  confine  this  doctrine  of  periodicity  to  health ;  for  in  the 
same  number  of  the  Lancet  you  will  find  the  following:  "  Is  it  not  strange  that  the 
profession  should  still  couple  remittency  (periodicity?)  exclusively  with  miasma 
or  malaria  as  a  cause  ?  Every  writer  who  has  professedly  treated  the  subject,  re- 
fers to  this,  seeming  to  be  totally  and  absolutely  unconscious  of  the  universality  of 
remission  (periodicity  ?)  as  a  law  of  all  disease."  Thus  far  I  have  quoted  from 
what  I  have  written  and  published  in  your  own  pages.  From  the  Unity  of  Disease, 
first  published  in  1838, 1  extract  the  following :— "  The  body  under  disease  exhibits 
revolutions  analogous  to  those  in  health ;  it  shows  a  similar  tendency  to  alternate 
motion  and  repose  ;  for,  periods,  more  or  less  regular,  are  observed  to  mark  the  ap- 
proach, duration,  and  interval  of  recurrence  of  the  morbid  phases."  And  in  the 
first  edition  of  the  Fallacies  of  the  Faculty,  published  in  1839,  is  the  following  :— 
'•  So  far,  however,  from  having  been  recognised  as  a  Law  of  universal  occurrence, 
harmonising  with  everything  which  we  know  of  our  ov:n  or  other  worlds,  periodic 
return  has  been  vaguely  supposed  to  stamp  the  disorders  where  it  was  too  striking 


218  APPENDIX. 

to  be  overlooked  as  the  exclusive  offspring  of  a  malarious  or  miasmatic  atmosphere." 
"  The  human  bodv,  whether  in  health  or  disorder,  is  an  epitome  of  ever 
system  in  nature.  Like  the  globe  we  inhabit,  it  has  in  health  its  diurnal  and  other 
revolutions,  its  sun  and  its  abide,  it*  times  and  seasons,  its  alternations  of  heat  and 
moisture.  In  disease,  we  recognise  the  same  long  chills  and  droughts,  the  same 
passionate  storms  and  outpourings  of  the  streams  by  which  the  earth  at  times  is 
agitated ;  the  matter  of  the  body  assuming  in  the  course  of  these  various  alternations, 
changes  of  character  and  composition,  such  as  tumours,  abscesses,  and  eruptions, 
typical  of  new-formed  mountain  masses,  iarthquakes,  and  volcanoes;  all  these,  too, 
like  the  tempests  and  hurricanes  of  nature,  intermitting  with  longer  or  shorter 
periods  of  tranquillity,  till  the  wearied  body  either  regains,  like  our  common  mo- 
ther, its  wonted  harmony  of  motion,  or  like  what  we  may  conceive  of  a  world  de- 
stroyed, becomes  resolved  into  its  pristine  elements."  In  these  extracts,  not  only 
have  I  given  the  doctrine  of  the  periodicity  of  health  and  disease  in  all  vitality,  but 
the  doctrine  of  Universal  Periodicity— of  the  Periodicity  of  all  nature  !  Further 
proofs,  if  further  proofs  be  wanted,  you  will  find  in  the  volume  I  have  already 
placed  in  your  possession ;  although  in  the  list  of  your  "  books  received"  you  have 
not  thought  it  politic  to  include  their  names.  Under  these  circumstances,  to  refuse 
to  print  my  charge  against  Dr.  Laycock  in  the  journal  that  contains  his  piracies, 
would  be  to  refuse  me  common  justice.  It  would  be  the  act  of  one  who  has  received 
stolen  goods,  knowing  them  to  be  stolen.  By  such  a  course,  you  would  reduce 
your  periodical  to  the  level  of  the  British  and  Foreign  Medical  Review,  the  Editor  of 
which,  Dr.  Forbes,  first  misquoted,  misrepresented,  and  then  endeavoured  to  divide 
the  honour  of  my  discovery  between  your  protege,  Dr.  Laycock.  and  his  Court 
colleague,  Dr.  Holland — Dr.  Holland,  whose  plagiarisms  I  had  so  fully  exposed  in 
the  volume  Dr.  Forbes  pretended  to  criticise.  In  his  number  for  January,  1843, 
Dr.  Forbes  damns  the  doctrine  of  periodicity  and  remittency,  when  it  comes  from 
me.  Three  short  months  afterwards  (April),  he  has  the  effrontery  to  print  the  fol- 
lowing : — •'  The  intermittent  nature  of  disease  must  most  certainly  be  better  under- 
stood before  we  can  practice  medicine  scientifically."  "  Dr.  Holland  has  an 
interesting  essay  on  the  subject  iu  his  Medical  Notes  and  Reflections,  and  more 
recently,  Dr.  Laycock  has  attempted  to  demonstrate  a  General  Law  of  Periodicity." 
"  If  his  researches  prove  to  be  correct,  a  considerable  change  must  necessarily  take 
place  in  both  the  theory  and  practice  of  medicine."  Such  baseness,  Sir,  is  perhaps 
unparalleled  in  the  history  of  any  science.  It  has  proved  to  me  that  I  had  neglected 
to  make  myself  acquainted  with  one  element  of  periodicity — periodical  rascality 
— an  element,  however,  I  am  pretty  well  prepared  to  encounter,  with  the  little 
monosyllable,  dates.  To  these  and  to  the  public — if  not  to  the  profession — I 
appeal.  I  am,  Sir,  your  most  obedient, 

S.  Dickson. 

This  letter  not  having  appeared  in  the  Lancet  on  the  next  day  of  publication,  I 
again  wrote  to  the  Editor,  Mr.  Wakley,  as  follows : — 

April  29,  1843. 

Sir,  I  herewith  convey  to  you  the  Medical  Times  of  this  day,  which  contains  the 
copy  of  a  letter  I  addressed  and  sent  to  you  on  the  day  of  its  date,  by  post.  As 
you  have  taken  no  notice  of  that  letter  in  this  day's  Lancet,  I  infer  that  you  suppose 
that  the  Conductor  of  a  Medical  Journal  may  dispense  with  the  common  feelings  of 
honour  and  justice,  that  every  man  pretending  to  the  rank  of  a  gentleman  is  careful 
to  evince  when  appealed  to,  in  your  position.  Therefore,  I  accuse  you,  Mr.  Thomas 
Wakley,  of  having  in  the  case  of  Dr.  Laycock,  received  stolen  goods,  knowing  them 
to  be  stolen — of  being  a  party  to  a  scandalous  and  contemptible  literary  swiudle — 
get  out  of  the  matter  how  you  can. 

I  am,  Sir,  your  most  obedient, 

S.  Dicksoh. 

This  letter  at  last  brought  a  reply  from  Dr.  Laycock,  the  nature  of  which  will  he 
seen  by  my  rejoinder.  In  a  subsequent  number  of  the  Lancet,  Mr.  Wakley  conde- 
scended to  denounce  me  as  a  quack  and  a  bully  ! 


To  the  Editor  of  the  Medical  Times. 

\:,th  May,  1843. 
Dr.  Laycock  having  at  last  thought  it  necessary  to  his  character  to  gel  op 
thing  like  a  reply  to  my  Letters,  on  the  lubjeel  of  hi*  recenl  piracies,  permit  me,  Mr. 
Editor,  to  beg  the  favour  of  your  Inserting  the  following  rejoinder.    Out  of  Disown 


APPENDIX.  219 

mouth,  I  have  convicted  this  physician  of  a  mean  plagiarism  of  my  doctrine  of  the 
periodicity  of  movement  of  all  vitality  ;  and  out  of  his  own  mouth  I  will  now  pro- 
ceed to  convict  hira  of  an  equally  disingenuous  attempt  to  shuffle  out  of  his  discre- 
ditable position. 

In  the  Lancet  for  25th  March  last,  in  a  paper  on  "  Vital  Periodicity,"  Dr.  L&y- 
cock  claims  to  have  demonstrated  five  propositions,  which  he  numbers  1,  2,  3,  4,  and 
5.  With  the  first  and  essential  one  only,  do  I  propose  to  deal.  "  1.  That  there  is 
a  general  law  of  periodicity,  which  regulates  all  the  vital  movements  of  all  animals.'' 
This,  with  the  other  four  propositions,  he  pretends  to  have  discovered.  "  To  pre- 
vent controversy,"  he  says,  "I  would  observe  that  these  propositions  contain  what 
I  claim  as  my  own" — Litcr<s  Scriptw  Moment.  So  much  for  what  he  claims:  let  us 
now  see  what  he  disclaims.  "  Dr.  Dickson,"  quoth  this  consistent  gentleman, 
"  asserts  that  it  has  been  the  labour  of  his  life  to  establish  the  discovery  of  the 
periodic  movement  of  all  vitality — of  the  periodicity  ot  life  in  health — of  the  perio- 
dicity of  life  in  disease — of  the  periodicity  of  movement  of  universal  nature  !  and 
that  he  won't  be  juggled  out  of  it  either  by  Mr.  Wakley,  Dr.  Holland,  or  Dr.  Lay- 
cock,  or  any  one  else.  Now  the  plain  truth  is,  that  the  unhappy  man  has  spent  his 
life  in  trying  to  crack  a  blind  nut,  and  his  charge  of  plagiarism  is  all  moonshine. — 
I  have  never  claimed  the  discovery  of  the  doctrine  in  question  !"  What,  then,  in 
the  name  of  common  sense,  does  this  "  respectable  physician"  claim  ?  What  does 
he  mean  by  the  manifold  productions  which,  under  the  head  "  Vital  Periodicity," 
he  has  been  palming  upon  the  British  Association  and  the  readers  of  the  Lancet  as 
his  discoveries! — discoveries  of  such  importance,  too,  as  in  the  eyes  of  his  patron  and 
fellow-plagiarist,  Dr.  John  Forbes,  must  eventually  change  the  whole  face  of  physic. 
"  Dr.  Laycock,"  says  the  immaculate  Forbes,  "  has  attempted  to  demonstrate  a 
general  law  of  Vital  Periodicity."  "  If  his  researches  prove  correct,  a  considerable 
change  must  necessarily  take  place  in  both  the  theory  and  practice  of  medicine." — 
His  researches !  Ay,  there's  the  rub.  The  value  of  the  discovery  of  this  great  na- 
tural law  or  principle — the  universality  of  periodic  intermission  and  return — being 
thus  distinctly  acknowledged,-  the  next  question  is,  to  whom  does  it  belong  ?  Not 
to  Dr.  Laycock  assuredly,  for  Dr.  Laycock  himself  has  now  abandoned  his  claim  to 
it ;  no,  nor  to  Dr.  Dickson  either,  he  adds,  "  for  this  best  of  reasons,  that  it  is  pro- 
bably just  as  old  as  the  pyramids."  Probably  not  quite  so  old,  Dr.  Laycock — other- 
wise, why  should  it  only  now,  for  the  first  time,  threaten  to  work  such  a  change  in 
the  theory  and  practice  of  medicine  ?  Something  more  satisfactory,  however,  than 
your  assertion  that  it  is,  will  be  required  at  your  hands  before  you  be  permitted  to 
get  out  of  the  controversy  you  have  so  deliberately  provoked — not  prevented ! — 
For,  keeping  to  "  probabilities"  still — as  it  is  just  probable  that  you,  Dr.  Laycock, 
may  try  to  cover  your  retreat  with  the  names  of  Hippocrates,  Aristotle,  Celsus,  or 
some  other  of  the  ancients,  I  mnst  be  so  plain  as  to  tell  you  that  names  alone  will 
neither  satisfy  the  public  nor  me.  No,  Sir,  if  you  still  adhere  to  your  latest  asser- 
tion— an  assertion  the  exact  converse  of  the  premises  with  which  you  set  out — if 
you  still  intend  to  convince  the  world  that  not  you,  but  I,  am  the  plagiarist,  I  now 
call  upon  you  to  produce  the  pages  and  passages  of  the  authors  by  which  you  may 
find  it  convenient  to  say  my  labours  have  been  anticipated ! 

The  quibbles  of  speech  to  which  you  have  descended,  will  scarcely  provoke  the 
smiles  of  your  friends ;  for  the  flippant  abuse  of  me,  which  you  have  done  me  the 
houour  to  introduce  in  your  letter,  I  thank  you  most  sincerely,  and  for  the  similar 
compliment  paid  me  in  last  week's  Lancet,  by  the  publisher  of  your  piracies,  Mr. 
Thomas  Wakley,  I  beg  to  offer  that  "honourable  gentleman"  my  best  acknowledg- 
ments. "  Quack  and  bully"  coming  from  him,  require  from  me  the  "  retort  courte- 
ous." The  next  time  my  "  honourable  friend,"  for  such  I  must  now  certainly  style 
him,  does  me  the  favour  to  publish  a  letter  of  mine,  I  hope  he  will  pursue  the  exact 
jame  course  he  has  done  on  this  occasion,  viz.,  bottle  it  up  for  five  mortal  weeks, 
then  mispoint  and  misprint  it,  substitute  commas  for  full  stops,  full  stops  for  com- 
mas, capitals  for  small  type,  and  vice  versa ;  and,  in  a  word,  so  unsentence  the  sen- 
tences, that  such  letter  shall  be  his  production  rather  than  mine.  Of  course  he  will 
take  care,  at  the  same  time,  to  suppress  any  correspondence  that  may  have  passed 
between  us  in  the  interval,  such  as  the  veiy  unimportant  letter  you,  Mr.  Editor,  have 
just  printed  in  the  Medical  Times,  thereby  confessing  to  the  world  his,  Mr.  Thomas 
Wakley's,  high  sense  of  my  merits — merits  so  distinguished  as,  in  his  view,  to  entitle 
me  to  nothing  short  of  the  identical  salutations  with  which  certain  respectable  gab- 
blers, in  times  gone  by,  welcomed  the  illustrious  Harvey  and  Jenner — the  stale 
cackle  of  "  quack,  quack,  quack !"  Yours,  Mr.  Editor, 

S.  Dickson. 

To  this  letter  there  was  no  reply ! 


220  APPENDIX. 

Dr.  Dickson  and  Dr.  Copland. 
To  the  Editor  of  the  Medical  Times. 

28,  Bolton  Street,  April  22nd,  1844. 

Sir, — In  your  Journal  of  last  week,  Dr.  Copland  is  reported  to  have  made  the 
following  observation  at  a  late  meeting  of  the  Westminster  Medical  Society — "  That 
within  his  recollection,  the  character  of  disease  in  London  had  changed  very  much. 
In  1820,  and  for  several  years  afterwards,  as  far  as  1826  or  1827,  disease  presented 
more  of  the  inflammatory  character ;  at  least,  patients  bore  depletion  better.  It 
had,  since  then,  gradually  changed,  and  had  assumed  the  intermittent  or  remittent 
type,  especially  in  the  outskirts.  There  is,  consequently,  less  toleration  of  deple- 
tion, even  in  cases  of  disease  of  the  chest."  Allow  me,  Sir,  to  put  Dr.  Copland 
right  on  this  subject ;  the  type  of  disease  has  not  changed,  neither  did  patients  bear 
blood-letting  better  formerly  than  now ;  but  medical  men  have  changed — they  have 
changed  their  opinions  of  the  nature  of  the  one,  and  the  value  of  the  other.  The 
type  of  disease  change !  Yes,  when  the  types  of  life  and  death  change.  Intermit- 
tent fever,  Mr.  Editor,  ever  has  been,  and  to  all  eternity  will  be,  the  type  of  all  dis- 
eases, in  London,  out  of  London,  in  Europe,  hi  Asia,  in  Africa,  in  America!  And, 
through  your  pages,  I  beg  to  tell  Dr.  Copland  that,  if  he  likes,  I  will  show  him  let- 
ters from  medical  practitioners,  which  bear  the  post-mark  of  every  quarter  of  the 
globe,  expressive  of  their  obligations  to  me  for  my  discovery  of  that  great  fact; 
many  of  them  army  and  navy  surgeons,  and  all  of  them  too  honest,  too  ingenuous, 
and  too  disinterested,  to  pretend  that  disease  has  changed  its  character,  rather  than 
themselves  have  changed  their  views  of  it!  Suum  cuique.  The  day  is  not  distant, 
when  quacks  only  will  resort  to  the  lancet  and  the  leech  for  any  disease — diseases 
of  the  chest  included.  Has  Dr.  Copland  never  read  the  Unity  of  Disease  ? — has  he 
never,  in  fact,  admitted  the  truth  of  the  doctrine'1. — or,  like  Dr.  Holland,  will  he  plead 
non  mi  recordo  ? 

S.  Dickson. 

To  this  letter  there  was  no  reply ! 


DR.    TURNER'S    NOTES. 

IntermiUency  of  Disease — Quinine. — That  there  are  those  in  our  own  country  who 
do  not  think  so  lightly  of  Dr.  Dickson's  views  of  Disease  and  its  Treatment  as  some 
people  pretend  to  do,  testimony  is  at  hand.  I  find  it  in  the  leading  article  of  the 
May  number  of  the  Western  Lancet,  published  at  Lexington,  Ky.,  from  the  pen  of  Dr. 
Thomas  D.  Mitchell,  the  learned  professor  of  Materia  Medica  and  Therapeutics  in 
the.  Transylvania  University.  Here  are  his  words:  "'The  doctrine  that  all  fevers, 
and  all  diseases  are  essentially  Intermittent,  has  long  been  before  the  public  ;  and 
while  we  are  ignorant  of  the  nature  and  source  of  Periodicity,  the  fact  of  Inter* 
mittence  is  as  well  established  as  any  other  in  Medicine."  Applying  this  position 
to  Fevers,  Dr.  Mitchell  says,  "  Well  aware  that  the  idolaters  of  a  false  diagnosis, 
li.i.-iil  on  imaginary  lesions,  which  have  no  practical  bearing  in  the  case,  will  stand 
aghast  at  this  announcement,  I  feel  it  to  be  my  duty  to  present  the  facts,  as  history 
— not  far  off,  in  Europe,  but  here  in  our  own  land, — exhibits  them."  Dr.  Mitchell 
then  details  many  wonderful  and  rapid  cures  in  a  variety  of  violent  fevers  wrought 
by  a  bold  and  judicious  use  of  that  must  prominent  of  the  Chrono-Thermal  reme- 
dies— the  Sulphate  of  Quinine,  which  in  his  satisfaction  he  styles  "  the  Samson  of 
the  Materia  Medica.  It  has  been  pretended  that  Dr.  Dickson's  views  are  not  so 
new  as  he  imagines.  To  this  it  is  answered,  that  the  Doctor  has  repeatedly  de- 
manded  the  proofs  and  the  dates,  but  in  vain. 

Blood  Letting- — The  following  is  the  Official  Report  of  the  Physicians  who  at- 
tended General  Harrison  in  his  last  illness.  The  italics  are  mine — comment  is  need- 
ier, "(in  Saturday,  March  27,  1811,  President  Harrison,  after  sever;. 1  days'  pre- 
vious indisposition,  was  seized  with  a  chill,  and  ether  symptoms  of  Fever  ;    M 

day.  Pneum  mia,  wiih  Congestion  of  the  Liver  and   Derangement  of  the  Stomach 
Imd  Bowels  was  ascertained  to  exist.     The  ago  and  dtbitity  of  the  patient,  with  the 

^ration,  forbade  a  resort  to  general  Wood4etting.     V 
(*.  i'..  Leeching  and  capping,)  blistering,  ami  appropriate  internal  remedies  subdaed 
ase  of  the  rongs  ana  liver,  but  the  stomach  and 
I  no    re  ;ain  n  health)   condition.     Finally,  en  the  3d  el'  April,  at   th 
clock,  p.m.,  profuse  diarrhoea  came  on,  under  which  ha  sank,  at  thirty  minutes  to  ouo 


APPENDIX.        .  221 

o'clock  on  the  morning  of  the  14th."  I  will  not  here  attempt  to  discuss  the  opinion 
whether  or  not  the  Lancet  can  be  altogether  dispensed  with  in  medical  practice — 
opinions  prove  nothing.  An  opinion  was  once  entertained  that  rivers  could1  not  be 
navigated  by  steam — Fulton  himself  doubted  the  safety  of  going  round  Point  Judith 
by  steam.  Philosophers  are  now  living  who  demonstrated  the  impracticability  of 
traversing  the  Atlantic  by  steam.  Yet  all  these  are  daily  done.  To  suppose  wo 
have  learnt  all  we  can  learn — that  the  progress  of  man  in  improvement  has  reached 
its  height,  is  to  suppose  that  the  Providence  of  the  Almighty  is  exhausted  or  ex- 
haustible. 

Dr.  Dickson  is  not  so  absurd  as  to  pretend  to  cure  all  his  patients,  as  certain  par- 
ties have  seemed  to  require  of  him.  But  he  claims — and  I  aver  it  with  him  from 
actual  experience — that  by  his  system  more  are  saved  ;  and  that  the  curable  cases 
are  relieved  in  much  shorter  time,  and  consequently  with  less  expense  and  with 
greatly  less  pain  and  suffering,  than  by  any  former  mode  of  treatment. — Is  all  this 
nothing  ? 

The  Duplex  Action  of  all  Medicines. — The  student  of  that  most  valuable  work  of 
Professor  Dungleson  of  Philadelphia, — New  Remedies,  is  struck  at  almost  every  page 
with  the  conflicting  and  opposite  views  expressed  by  practitioners  in  reference  to 
the  effects  of  the  various  medicines  therein  treated  of.  Bf  some,  a  particular  re- 
medy is  extolled  in  high  terms ;  by  others  it  is  declared  to  be  of  little  value.  Does 
not  Dr.  Dickson  furnish  the  key  to  these  conflicting  opinions  in  the  Duplex  Action 
of  all  Medicines  ? 

Palsy,  Apoplexy,  and  Diseases  of  the  Brain. — Sir  George  Lefevre,  without  acknow 
ledgment,  avails  himself  largely  of  Dr.  Dickson's  writings  : — "  Dr.  Baillie  said  in 
his  day,  that  Palsy  was  on  the  increase.  It  is  not  improbable  that  the  universal 
system  of  blood-letting  upon  all  such  attacks,  and  even  threatenings  of  them,  has 
converted  remedial  into  incurable  diseases.  Paralysis  has  sometimes  immediately 
followed  the  depletion  intended  to  prevent  Apoplexy  ;  and  when  this  plan  has  been 
persevered  in  for  the  relief  of  flow  of  blood  to  the  head,  Debility  of  Brain,  (erro- 
neously so  called  !)  is  not  an  uncommon  consequence.  Dr.  Holland  has  comment- 
ed very  freely  upon  this,  having  known  cases  of  this  kind,  where  bleeding  has 
been  immediately  followed  by  convulsions  of  Epileptic  character — occasionally  by 
amaurosis  or  deafness;  more  frequently  still  by  rambling  delirium — and  where 
wine  or  other  cordials  have  as  speedily  abated  these  tendencies." — Apology  for  the 
Nerves,  London,  1844. 

Concussion  from  Fall. — "  Sir  Charles  Bell  has  stated,  I  think,  that  when  a  man 
is  taken  up  in  the  street  apparently  lifeless  from  the  concussion  of  a  fall,  the  nurse 
gives  him  a  dram,  and  the  surgeon  bleeds  him  ;  but  the  nurse  is  right.  In  St.  Pe 
tersburg  I  was  requested  to  bleed  a  gentleman  who  had  fallen  from  his  desk  in  a 
fit — a  Cordial  was  administered,  which  soon  revived  the  patient,  who  had  been 
long  in  a  nervous  state  of  health." — Lefevre,  in  1844. 

Inflammation  and  Spitting  of  Blood. — C.  T.,  junior,  aged  seventeen,  Westchester 
County,  in  the  summer  of  1837,  having  a  pain  in  the  bowels,  undertook  to  treat  it 
by  swallowing  a  country  remedy  for  the  complaint,  composed  of  Powdered  Cay- 
enne Pepper  and  Cider.  In  his  haste  he  inhaled  into  his  wind-pipe  a  portion  of  the 
unmoistened  pepper ;  the  consequences  were  of  the  most  violent  kind — extreme 
irritation  of  the  throat,  great  pain  and  increased  action  of  the  heart  and  arteries  of 
the  most  prodigious  character.  I  arrived  an  hour  or  two  after  the  affair,  and  found 
a  Physician  in  attendance.  On  consultation,  guided  by  the  only  light  we  possessed 
— I  had  not  then  seen  Dr.  Dickson's  work — copious  bleeding  was  resorted  to,  and 
repeated  during  the  night,  until  the  patient  lost  some  forty  to  fifty  ounces.  The 
next  morning  the  symptoms  were  found  to  have  entirely  subsided.  The  patient, 
however,  was  pale  and  feeble;  in  a  few  weeks  he  got  about;  but  he  never  was  him- 
self again.  On  the  approach  of  every  winter  since,  he  has  been  the  subject  of  some 
form  of  disease.  In  October  last,  1844,  he  was  seized  with  Spitting  of  Blood.  At 
the  end  of  a  fortnight,  getting  no  better,  he  came  to  town,  and  arrived  at  my  door 
at  midnight,  drenched  with  rain.  I  found  him  with  a  hurried  circulation  and  res- 
piration, an  anxious  countenance,  and  every  few  minutes  coughing  up  a  mouthful 
of  a  frothy  mixture  of  mucus  aud  arterial  blood.  "I  had  him  put  into  a  warm  bed, 
between  blankets,  and  gave  him  a  powerful  opiate,  following  it  the  next  day  with 
Quinine.  He  coughed  but  once  during  the  night.  In  the  morning,  I  found  him 
comfortable^hid  his  skin  moist  fi*>m  head  to  foot ;  but  he  had  some  pain  on  taking 
a  long  inspiration,  until  the  middle  of  the  next,  or  second  day,  when  all  the  symp- 
toms subsided ;  on  the  third  day,  he  dressed  himself  and  took  his  seat  at  the  din- 


222  DR.  turner's  notes. 

* 

ner-table.  On  the  eighth  day,  against  my  advice,  he  went  into  the  country-  to  vote 
at  the  election,  had  a  relapse,  but  did  not  return  to  me  for  ten  day?,  when  the  treat- 
ment vies  repeated  with  a  like  result, — namely,  his  appearance  at  the  dinner-table, 
free  from  all  symptoms  but  weakness,  on  the  third  day.  He  was  rather  more  pru- 
dent this  time,  and  at  the  end  of  a  fortnight  he  was  enabled  to  resume  his  business; 
and  by  continuing  the  Chrono-Thermal  Treatment,  he  actually  gained  in  mid-winter 
seven  and  a  half  pounds  in  weight  more  than  he  had  ever  weighed  in  his  life.  At 
the  end  of  two  months,  thinking  himself  beyond  the  danger  of  another  attack,  he 
underwent  great  exposure  in  the  open  air,  nearly  the  whole  of  the  coldest  day  of 
the  last  winter,  ffhis  temerity  brought  him  for  the  third  time  into  my  hands,  with 
an  attack  more  violent  than  either  of  the  two  preceding.  The  Chrono-Thermal 
Treatment  again  proved  his  friend,  and  he  is  now,  April  8th,  in  the  prosecution  of 
his  business,  free  from  disease,  with  a  reasonable  prospect  of  continuing  so,  with 
proper  care,  at  least,  until  the  recurrence  of  another  winter. 

On  the  4th  of  January,  1845, 1  was  called  to  see  W.  W.,  aged  25,  who  was  spitting 
blood.  The  Chrono-Thermal  remedies,  in  a  few  days,  removed  his  disease  ;  and 
on  the  twelfth  day  he  returned  to  his  occupation  perfectly  well,  and  has  so  conti- 
nued throughout  the  winter. 

Palpitation. — J.  B.  came  to  me  with  palpitation  of  the  heart.  He  had  been  exa- 
mined with  the  stethoscope,  and  pronounced  incurable.  On  inquiry,  the  palpita- 
tion proved  to  be  intermittent ;  there  was  also  great  flatulence.  I  gave  him  some 
pills  of  silver  and  cyanide  of  potassium.  At  the  end  of  a  week  he  returned,  and, 
on  my  asking  him  how  he  was,  he  laughed,  and  replied,  "  I  hope  I  may  never  be 
•worse'."  »■  At  the  end  of  a  month,  the  palpitation  had  wholly  disappeared,  and  he 
has  had  no  return  of  it. 

Fever  and  Inflammation. — "  Patients,  who  have  been  apparently  cured  by  large 
bleedings,  which  have  conquered  pain  in  the  first  instance,  remain  eventually  lon- 
ger in  the  hospitals  than  those  who  have  not  been  so  speedily  relieved ;  moreover, 
you  will  find  them  return  again,  after  their  dismissal,  with  dropsy  and  chronic  af- 
fections."— Lefevre,  m  1844. 

Abstinence. — In  the  summer  of  1843,  an  eminent  citizen  of  this  state  laboured  un- 
der that  form  of  Influenza  then  known  by  the  sobriquet  of  "  Tyler  grippe."  He 
conceived  the  idea  that  he  could  starve  it  out ;  consequently,  he  confined  himself 
to  a  rigorously  abstemious  diet — a  little  boiled  fish  for  djnner,  with  a  dessert  of  wa- 
ter-melon.    At  the  end  of  a  fortnight,  he  was  seized  with  Palsy  of  one  side. 


June  17  th,  1847. 


Dear  Sir, — Accident  placed  in  my  hands,  about  one  year  or  fifteen  months  since, 
a  copy  of  your  edition  of  Dr.  Samuel  Dickson's  "  Chrono-Thermal  System  of  Medi- 
cine," &c.  After  a  careful  perusal  of  it,  you  can  scarcely  imagine  the  debght 
which  it  afforded  me.  For  years  I  have  been  gradually  losing  confidence  in  the 
prescribed  mode  of  treatment  laid  down,  and  forced  on  the  profession,  through  the 
talismanic  influence  of  either  fashionable  or  time-honoured  professors,  or  our  medical 
schools  ;  and  have  for  many  years  past  adopted  a  plan  of  treatment,  in  many  of  its 
essential  features,  similar  to  that  so  forcibly  pointed  out  by  Dr.  Dickson.  But  the 
happy  thought  of  adopting  intermittent  fever  as  the  type  of  disease,  so  clearly 
illustrated  by  the  doctor,  never  once  entered  my  mind ;  although  I  had  for  some 
years  been  using  the  chrono-thermal  remedies,  from  observing  the  great  and  benefi- 
cial effects  derived  from  their  use,  and  had  almost  ceased  to  use  the  lancet,  drastic 
purgatives,  &c.,  from  the  clearly-demonstrated  ill  effects  which  so  often  followed 
in  their  wake.  Yet  my  mode  of  treatment  was  empirical.  The  great  book  of  na- 
ture was  open  to  me ;  I  was  anxiously  inquiring  for  some  happy  generalisation  that 
might  enable  me  to  condense  the  facts  and  observations  which  I  had  made  into  a 
system. 

You  can  now  in  a  faint  degree~npprceiNte  the  deti£hl  with  which  I  read  the 
Weriodie  Theory  of  Dr.  Dickson.     I  instantlyMT&rnveivil.  that  every  fad  which  r  had 

• 


i  limn/  oi  UT,  mcKson. .    I  instant  lyMisrovereii.  I  wlnelil 

observed  during  a  practice  of  near  twentj  -\y  e  j  ears  as  ato  i  e  arratraLunder 
beautiful,  natural  periodic  system  q£J$r.'DjMupB-^lhfl  p  enrtkue, 


CA-i 


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